An Observational Study of Clinical Profile & Short-Term Outcome with Use of Pulse Therapy of Methylprednisolone Alone Vs Methylprednisolone and Intravenous Immunoglobulin In Multisystem Inflammatory Syndrome In Children

Abstract

Background^: Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. There is persistent fever along with inflammation, which can lead to medical emergencies and neonates and children may require critical care. Aims and objectives: This study evaluates use of pulse therapy of methyl prednisolone versus prednisolone and intravenous immunoglobulin (IVIG) in multisystem inflammatory syndrome in children (MISC). Methodology: This analytical study was carried out in 30 children with history of SARS-CoV-19 or MISC attending the PICU or NICU of the Tertiary care centre of DVVPF’s Medical College, Ahmednagar. The study was carried out from January 2021 to December 2021. Results: Total of 30 patients were studied with male majority (60%), and mean age of 7.35 years. 28 were kept in the ICU (93.33%). GI symptoms were seen in 24 cases (80%), Mucocutaneous manifestation in 25 cases (83.33%), Multiorgan involvement (>3 organs) in 23 cases (76.67%). D Dimer was raised in 29 cases (96.67%), Thrombocytopenia was seen in 24 cases (80%). CNS involvement in 14 cases (46.67%) with headaches in 7 (23.33%), encephalopathy in 5 cases (16.67%) and seizures in 4 cases (13.33%). Respiratory system involvement was seen in 16 cases (53.33%). We observed that the outcome characteristic features were better in the Methylprednisolone pulse therapy plus IVIG group. (p<0.05) Out of 15 patients in the two groups, 3 patients died in Methylprednisolone pulse therapy group (20%) while there was one death in the Methylprednisolone pulse therapy plus IVIG group. Significant difference was seen in the survival of the two groups. (p = 0.04). Conclusion: There is improvement in both the groups which received the treatment with either Methylprednisolone pulse therapy or Methylprednisolone pulse therapy plus IVIG. Comparatively there was less ICU stay, less complications and better patient survival in Methylprednisolone pulse therapy plus IVIG group.