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 4. Case 2. Hematological findings in a 14-year-old girl with multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection.
Data | Day 1 | Day 3 | Day 5 | Day 6 | Day 8 | Day 16 |
---|---|---|---|---|---|---|
Treatment | Admission | IVIG | +mPDN+IVIG +enoxaparin +furosemide +albumin | Discharge | ||
Hb (g/dL) | 12.9 | 12.2 | 12.3 | 10.9 | 11.2 | 12.5 |
WBC (/µL) | 5710 | 6320 | 10 970 | 9920 | 10 230 | 11 360 |
Neu/lymph (%) | 83/10.9 | 85.5/10.8 | 92.2/5.7 | 91/7 | 89/10 | 82.3/13.9 |
Platelet (/µL) | 132 000 | 90 000 | 121 000 | 112 000 | 255 000 | 209 000 |
CRP (range | 5.82 | 21.16 | 13.23 | 13.7 | 3.73 | 0.27 |
Procalcitonin (range 0.02–0.05 µg/L) | 0.59 | 5.20 | 3.58 | 1.87 | 0.57 | |
Protein/albumin (g/dL) | /4.1 | 7.4/3.6 | 5.8/3 | 5/2.4 | 8/2.8 | 8.2/3.7 |
Creatinine (mg/dL) | 1.29 | 1.07 | 0.72 | 0.63 | 0.62 | |
Na/K/Cl (mmol/L) | 134/3.29/104 | 139/4.04105.5 | 136/4.16/108 | 133/4.47/101 | 134/4.56/100 | |
Mg/P/Ca (mg/dL) | 1.94/2.2/8.4 | 1.97//8.1 | 1.77/2.4/7.2 | 1.79/2.4/7.8 | 1.82/3.5/9.1 | |
AST/ALT (UI/L) | 87/56 | 92/72 | 156/80 | 152/76 | 275/122 | 66/125 |
CPK/LDH (UI/L) | 717/512 | 2258/445 | 12 542/581 | 10 966/454 | 13 093/321 | 869/197 |
Gamma GT (UI/L) | 51 | 31 | 34 | 20 | 19 | |
Pancreatic amylase (U/L) | 32 | 44 | ||||
Troponine (ng/L) | 12.50 | 244 | 114 | 103 | 42.8 | |
INR/APTT | 1.31/30.8 | 2.86/ | 1.3/29.2 | 1.35/28.4 | 1.31/26.8 | |
D-dimer (ng/mL) | 1.66 | 3.14 | ||||
Fibrinogen (mg/dL) | 487 | 596 | 553 | 483 | 368 | 179 |
Ferritin (range 10–232 ng/mL) | 815 | 504.9 | ||||
Triglyceride levels (mg/dL) | 194 | 165 | ||||
CK-MB (µg/L) | 11.40 | 3.77 | 7.88 | |||
Myoglobin (range 25–58 ng/mL) | 637 | 1678 | 2081 | 1682 | 852 | |
Troponin (range | 114 | 103 | 50.5 | |||
IVIG – intravenous immunoglobulin; Hb – hemoglobin; WBC – white blood cells; Neu/lymph – neutrophils/lymphocytes; CK-MB – creatine kinase-MB; CRP – C-reactive protein; Na/K/Cl – sodium/potassium/chloride; Mg/P/Ca – magnesium/phosphorous, calcium; AST/ALT – aspartate transaminase/alanine transaminase; CPK/LDH – creatine phosphokinase/lactate dehydrogenase; INR/APTT– international normalized ratio/activated partial thromboplastin time. |