Abstract and Introduction
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory state that occurs after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We present 2 cases of MIS-C after SARS-CoV-2 vaccination; 1 patient had evidence of recent SARS-CoV-2 infection. Our findings suggest that vaccination modulates the pathogenesis of MIS-C.
Introduction
Multisystem inflammatory syndrome in children (MIS-C) was first described in 2020 during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.[1] MIS-C is a systemic hyperinflammatory state necessitating hospitalization in patients <21 years of age who experienced ≥24 hours of fever, recent SARS-CoV-2 exposure or positive testing, involvement of ≥2 organ systems, and ≥1 of the following laboratory results: elevated C-reactive protein (CRP), erythrocyte sedimentation rate, fibrinogen, procalcitonin, D-dimer, ferritin, lactate dehydrogenase, interleukin-6, neutrophils, reduced lymphocytes, or reduced albumin.[2] It is unknown whether vaccination can precipitate or abrogate MIS-C and whether natural infection preceding or at the time of vaccination plays a role.[1] We describe MIS-C in 2 adolescents recently vaccinated with BNT162b2 (Pfizer-BioNTech, https://www.pfizer.com) and raise the possibility of vaccination modulating MIS-C pathogenesis.
