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12 October 2021: Articles

A 7-Year-Old Boy and a 14-Year-Old Girl Initially Diagnosed with Toxic Shock Syndrome and Tested Positive for SARS-CoV-2 Infection, Supporting a Diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C)

Unusual clinical course, Challenging differential diagnosis, Management of emergency care

Salvatore Giordano A , Maria Concetta Failla A , Maria Grazia Li Cavoli A , Domenico Romano B , Veronica Vanella B , Chiara Caruso B , Ilenia Chillura B , Maria Cristina Maggio A*

DOI: 10.12659/AJCR.931570

Am J Case Rep 2021; 22:e931570

Table 2. Case 1. Hematological findings in a 7-year-old boy with multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection.

DataDay 1Day 2Day 3Day 4Day 5Day 9Day 14
TreatmentIVIGAlbumin+mPDNAlbumin
Hb (g/dL)10.89.99.29.89.410.611.2
WBC (/µL)7880538011 55015 78015 66033 38020 800
Neu/lymph (%)91.9/5.583.7/9.983.9/10.584.8/10.182.7/9.575.9/14.980.2/10.7
Platelets (/µL)210 000197 000279 000360 000405 000942 000719 000
CRP (range27.7924.449.365.172.931.160.15
Procalcitonin (µg/L)176.3110087.9335.8310.031.070.31
Protein/ albumin (g/dL)6.9/3.46.3/6.5/2.56.3/2.77.1/4.48/4.18.6/4.4
Creatinine (mg/dL)0.530.510.330.440.350.440.37
Na/K/Cl (mmol/L)124/4.22/86126/4.51/96132/3.92/104134/3.8/104133/3.39/100134/5.37/95133/4.51/95
Mg/P/Ca (mg/dL)2.53/2.4/8.92.53/4/8.21.9/2.9/7.91.95/3.5/8.13.7/8.2/8.22.49/4.6/9.32.20/3.8/9.9
AST/ALT (UI/L)273/254215/20189/12252/9350/7943/9328/57
CPK/LDH (UI/L)26/45440/37627/23222/21223/22024/39527/230
Gamma GT (UI/L)30725618416213238
Pancreatic amylase/lipase (U/L)12100/216136/10323/17
Troponine (ng/L)27.3
INR/APTT1.37/15.30.94/28/24.41.01/24.81.04/25.1/21.70.98/20.8
D-dimer2.792.482.92.213.064.460.73
Fibrinogen932717481381244175189
Ferritin297621341445109.4276.2
Triglyceride levels460485
IVIG – intravenous immunoglobulin; Hb – hemoglobin; WBC – white blood cells; Neu/lymph – neutrophils/lymphocytes; CRP – C-reactive protein; Na/K/Cl – sodium/potassium/chloride; Mg/P/Ca – magnesium/phosphorous, calcium; AST/ALT – aspartate transaminase/alanine transaminase; CPK/LDH – of creatine phosphokinase/lactate dehydrogenase.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923