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EAACI statement on the pathogenesis, immunology, and immune-targeted management of the Multisystem Inflammatory Syndrome in Children (MIS-C) or Pediatric Inflammatory Multisystem Syndrome (PIMS).
  • +21
  • Wojciech Feleszko,
  • Magdalena Okarska-Napierała,
  • Emilie Pauline Buddingh,
  • Marketa Bloomfield,
  • Anna Sediva,
  • Carles Bautista-Rodriguez,
  • Helen Brough,
  • Philippe Eigenmann,
  • Thomas Eiwegger,
  • Andrzej Eljaszewicz,
  • Stefanie Eyerich,
  • Cristina Gomez-Casado,
  • Alain Fraisse,
  • Jozef Janda,
  • Rodrigo Jiménez-Saiz,
  • Tilmann Kallinich,
  • Inge Kortekaas Krohn,
  • Charlotte Mørtz,
  • Joaquin Sastre,
  • Milena Sokolowska,
  • Ziemowit Strzelczyk,
  • Eva Untersmayr,
  • Gerdien Tramper
Wojciech Feleszko
Warszawski Uniwersytet Medyczny

Corresponding Author:wojciech.feleszko@wum.edu.pl

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Magdalena Okarska-Napierała
Warszawski Uniwersytet Medyczny
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Emilie Pauline Buddingh
Leids Universitair Medisch Centrum
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Marketa Bloomfield
Univerzita Karlova
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Anna Sediva
Univerzita Karlova
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Carles Bautista-Rodriguez
Royal Brompton Hospital
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Helen Brough
King's College London School of Life Course Sciences
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Philippe Eigenmann
Hopitaux Universitaires Geneve
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Thomas Eiwegger
Karl Landsteiner Privatuniversitat fur Gesundheitswissenschaften GmbH
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Andrzej Eljaszewicz
Uniwersytet Medyczny w Bialymstoku
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Stefanie Eyerich
Zentrum Allergie und Umwelt
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Cristina Gomez-Casado
Heinrich-Heine-Universitat Dusseldorf Medizinische Fakultat
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Alain Fraisse
Royal Brompton Hospital
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Jozef Janda
Univerzita Karlova
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Rodrigo Jiménez-Saiz
Instituto de Investigacion del Hospital de La Princesa
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Tilmann Kallinich
Charite Universitatsmedizin Berlin
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Inge Kortekaas Krohn
Vrije Universiteit Brussel - Brussels Health Campus
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Charlotte Mørtz
Odense Universitetshospital
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National University of Singapore Yong Loo Lin School of Medicine
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Joaquin Sastre
Instituto de Salud Carlos III
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Milena Sokolowska
Universitat Zurich Schweizerisches Institut fur Allergie- und Asthmaforschung
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Ziemowit Strzelczyk
Warszawski Uniwersytet Medyczny
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Eva Untersmayr
Medizinische Universitat Wien
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Gerdien Tramper
Franciscus Gasthuis & Vlietland Willemsplein
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Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately four weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.
05 Dec 2022Submitted to Pediatric Allergy and Immunology
05 Dec 2022Assigned to Editor
05 Dec 2022Submission Checks Completed
05 Dec 2022Review(s) Completed, Editorial Evaluation Pending
05 Dec 2022Editorial Decision: Accept