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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.

DataDay 1Day 3Day 5Day 6Day 8Day 16
TreatmentAdmissionIVIG+mPDN+IVIG +enoxaparin +furosemide +albuminDischarge
Hb (g/dL)12.912.212.310.911.212.5
WBC (/µL)5710632010 970992010 23011 360
Neu/lymph (%)83/10.985.5/10.892.2/5.791/789/1082.3/13.9
Platelet (/µL)132 00090 000121 000112 000255 000209 000
CRP (range5.8221.1613.2313.73.730.27
Procalcitonin (range 0.02–0.05 µg/L)0.595.203.581.870.57
Protein/albumin (g/dL)/4.17.4/3.65.8/35/2.48/2.88.2/3.7
Creatinine (mg/dL)
Na/K/Cl (mmol/L)134/3.29/104139/4.04105.5136/4.16/108133/4.47/101134/4.56/100
Mg/P/Ca (mg/dL)1.94/2.2/8.41.97//8.11.77/2.4/7.21.79/2.4/7.81.82/3.5/9.1
AST/ALT (UI/L)87/5692/72156/80152/76275/12266/125
CPK/LDH (UI/L)717/5122258/44512 542/58110 966/45413 093/321869/197
Gamma GT (UI/L)5131342019
Pancreatic amylase (U/L)3244
Troponine (ng/L)12.5024411410342.8
D-dimer (ng/mL)1.663.14
Fibrinogen (mg/dL)487596553483368179
Ferritin (range 10–232 ng/mL)815504.9
Triglyceride levels (mg/dL)194165
CK-MB (µg/L)11.403.777.88
Myoglobin (range 25–58 ng/mL)637167820811682852
Troponin (range11410350.5
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.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923