Neck symptoms a common sign of MIS-C, researchers find

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Symptoms of neck inflammation are a common sign of childhood multisystem inflammatory syndrome, a serious condition linked to SARS-CoV-2 infection, researchers reported in the Journal of the Pediatric Infectious Diseases Society.

Elan Jenkins, MD, an assistant professor of pediatrics at Emory University School of Medicine, and colleagues identified 137 children diagnosed with MIS-C at Children’s Healthcare of Atlanta between March 2020 and January 20, 2021.

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Of the 137 patients diagnosed with MIS-C, 39 (28.5%) had neck-related symptoms, with 38 patients reporting neck pain. Three patients had trismus and five reported drooling, dysphagia or difficulty swallowing, according to Jenkins and colleagues.

Twelve patients underwent neck imaging and four had signs of retropharyngeal edema/inflammation. All patients treated for retropharyngeal edema were 13 years of age or older.

According to the authors, retropharyngeal edema has been documented in Kawasaki disease, which has been compared with MIS-C. All MIS-C patients with retropharyngeal edema were 4 years and older, “which is incongruous with the typical epidemiological distribution of purulent retropharyngeal infection,” Jenkins and colleagues wrote.

They noted a recent study from the United Kingdom with common reports of neck pain in patients with MIS-C, and a US study in which neck pain was associated with a higher risk of MIS-C than other febrile conditions.

“In conclusion, neck symptoms are a relatively frequent manifestation of MIS-C and can be considered a separate clinical system related to diagnosis,” Jenkins and colleagues wrote.

References:

Carlin RF, et al. J Pediatrician. 2021; doi: 10.1016/j.jpeds.2020.10.013.

Cheong RCT, et al. JAMA Otolaryngol Head Neck Surg. 2021;doi:10.1001/jamaoto.2020.5698.

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