New Viral Inflammatory Syndrome in Children

I'd like to share with you some interesting news about kids and teenagers and COVID-19. A lot of attention has been paid to those over age 65, and in my last last video update and news blogs I've shared how younger adults in the late 30s to mid 50s have been showing up in Emergency rooms with blood clots and some with stokes and being COVID-19 positive. There is an unusual inflammatory syndrome in kids and teens linked with COVID-19. I have evaluated children with abdominal pain and have had parents ask about their child's abdominal pain, fever, or nausea and vomiting but there are now additional considerations in light of recent reports.  73 children in New York State as of May 10th have had an initial presentation of a  persistent high fever over several days and significant abdominal pains with repeated vomiting; and the child doesn't feel any better or different after the vomiting which is not typical. The new condition has been called Pediatric Multi-System Inflammatory Syndrome. Symptoms progress from the persistent fever to extreme inflammation with the involvement of one or more organs that are compromised. So far these symptoms resemble a rare disease called Kawaski Disease Shock Syndrome (KDSS).   Kawasaki disease (KD) is an acute illness in children involving fever with symptoms including rash; conjunctivitis; redness in the lips, tongue and mucous membranes of the mouth and throat; swollen hands and/or feet; and sometimes an enlarged group of lymph nodes on one side of the neck.  Some children with the condition develop enlargement of the coronary arteries and aneurysms in those blood vessels. A small number of Kawaski cases progress to symptoms of shock where the blood pressure can go so low that there is not enough blood flow to supply oxygen and remove waste from the body's vital organs. Both KD and KDSS mostly affect young children but has been seen in teenagers.  The new syndrome has the some of the features of KD or KDSS such as the rash, conjunctivitis, and swollen hands or feet. Like the KD and KDSS it affects young children and also teenagers. What is different in the the new inflammatory COVID-19 syndrome is that there seems to be a lot more cardiac inflammation  which is usually very rare in KD or KDSS. More of these cardiac inflammation cases have been seen in New York City and London, which incidentally have very large numbers of COVID-19 cases. Other patients exhibit symptoms more similar to toxic shock syndrome, with abdominal pain, vomiting and diarrhea, and high levels of inflammation in the body, including the heart. Most cases are treated in the intensive care unit. Treatment includes intravenous immunoglobulin, which can "calm the immune system," , as well as steroids and cytokine blockers.The evidence so far from Europe, where reports of the syndrome first emerged, suggests most children will recover with proper supportive care. Most children with the syndrome,  have either tested positive for a current infection with the coronavirus, or for antibodies to the virus; in which case they may have been infected earlier and recovered.  According to case reports, some of the kids with the inflammatory syndrome who tested negative on coronavirus tests had been exposed at some point to someone known to have COVID-19. The inflammatory syndrome can appear days to weeks after COVID-19 illness, which suggests the syndrome arises out of the immune system's response to the virus. One theory is that as one begins to make antibodies to SARS-COV-2 with the antibody itself provoking an immune response. This seems to be  happening in susceptible individuals whose immune systems are genetically or environmentally altered (from past infections, vaccines or maybe allergies)  to react in a particular way. It doesn't happen in every child. It's still a really uncommon event.

Therefore, if your child or a child you know has a  persistent high fever over several days and significant abdominal pains with repeated vomiting; and the child doesn't feel any better or different after the vomiting you should at least call your pediatrician right away and get evaluated.

 

In continuing our series on brain fog I'd like to share with you a short 5 minute introductory video on the mitochondria and a product called Mitomax.  You can watch it here and we will be discussing more about the mitochondria and other topics next week.

Author
Jeffrey Mark, M.D. Helping clients with compassionate and comprehensive medical care for over 25 years with 4 board certifications in functional medicine, gastroenterology, internal medicine, and anti-aging/ regenerative medicine . IFMCP, ABIM Gastroenterology, NPAS Internal Medicine, ABAARM.

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