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We describe six teenagers presenting with fever and severe abdominal symptoms admitted with concerns for multisystem inflammatory syndrome in children (MIS-C). Laboratory evaluation revealed elevated markers of inflammation, lymphopenia, and increased D-dimers. Imaging studies revealed multifocal airspace disease and ground-glass opacities. SARS-CoV-2 polymerase chain reaction and serologies were negative. All patients reported a history of vaping, prompting E-cigarette, or vaping, product use-associated lung injury (EVALI) diagnosis. MIS-C has overlapping clinical and laboratory features highlighting the added challenge of diagnosing EVALI during the COVID-19 pandemic. Keywords COVID-19 pandemic, EVALI, MIS-C.
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http://dx.doi.org/10.1002/ppul.25558 | DOI Listing |
Medicine (Baltimore)
August 2025
Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Rationale: This case report highlights the complex clinical course and successful multidisciplinary management of a pediatric patient with multisystem inflammatory syndrome in children (MIS-C), who posed clinical dilemma at presentation. It underscores the ongoing clinical relevance of MIS-C as a post-Coronavirus disease 2019 sequelae and emphasizes the importance of maintaining a high index of suspicion for MIS-C in pediatric differential diagnoses, especially when symptoms overlap with other common conditions.
Patient Concerns: An 11-year-old previously healthy Saudi girl presented with gastrointestinal symptoms initially suggestive of acute appendicitis.
Lancet Digit Health
August 2025
Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Electronic address:
Background: In 2021, we used the National COVID Cohort Collaborative (N3C) as part of the National Institutes of Health RECOVER Initiative to develop a machine learning pipeline to identify patients with a high probability of having post-acute sequelae of SARS-CoV-2 infection or long COVID. However, the increased home testing, missing documentation, and reinfections that characterise the pandemic beyond 2022 necessitated the re-engineering of our original model to account for these changes in the COVID-19 research landscape.
Methods: Trained on 72 745 patient records (36 238 with long COVID and 36 507 with no evidence of long COVID), our updated XGBoost model gathered data for each patient in overlapping 100-day periods that progressed through time and issued a probability of long COVID for each 100-day period.
Front Pediatr
July 2025
Department of Propaedeutics of Pediatrics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Background: The clinical overlap syndrome between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD), particularly in the context of SARS-CoV-2 infection, presents diagnostic challenges. The presence of both complete and incomplete Kawasaki-like phenotypes (KLP) further complicates differentiation. This study aimed to analyze Kawasaki-like phenotype of MIS-C, its clinical features, and improve diagnostic accuracy, patient outcomes.
View Article and Find Full Text PDFPediatr Res
June 2025
Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Neutrophils, specialized cells of the early innate immune response, are important for maintaining the body's internal homeostasis. Upon invasion by foreign microbes, neutrophils are swiftly activated and recruited to the infection site, where they perform bactericidal functions through phagocytic clearance, degranulation-mediated toxin release, and NADPH oxidase-dependent killing. While their presence is crucial in the early stages of inflammation to combat infection, the prolonged engagement of neutrophils at the infection site can cause tissue damage due to apoptosis and the release of cytotoxic mediators.
View Article and Find Full Text PDFJ Trop Pediatr
June 2025
Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, 110031, India.
Early differentiation between severe multi-inflammatory syndrome in children (MIS-C) and severe presentations of dengue, scrub typhus, and other endemic tropical infections could help clinicians devise appropriate treatment strategies. This study aims to identify the diagnostic markers that may be used to discriminate between MIS-C versus endemic tropical infections, namely dengue and scrub typhus, which frequently occur in endemic areas. A retrospective study was conducted in a pediatric intensive care unit (PICU) of a tertiary care center in New Delhi, India between 2020 and 2023.
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