Multisystem Inflammatory Syndrome: A Diagnostic Dilemma

The incidence and severity of illness due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection showed more severe illness in adults and the elderly compared to children. But a clinical manifestation characterized by a multisystem inflammatory syndrome is described in children (Multisystem inflammatory syndrome in children (MIS-C)). MIS-C was first described in April 2020. MIS-C is due to a dysregulated immune response. The mechanism by which SARS-CoV-2 triggers the abnormal immune response is unknown. This abnormal immune response has similarities with Kawasaki and macrophage activation syndrome (MAS). Initially, due to a lack of awareness, MIS-C was underdiagnosed. At present, with increased awareness among pediatricians and due to a lack of characteristic clinical features and specific laboratory investigations, MIS-C has been overdiagnosed.