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No proven association

This stub is sort of a mess. The first mention of COVID-19 states that there is no proven association, which comes across as a major non-sequitur given that the reader has, in the context of this article, been given no prompt that one might be expected. Article should mention at the outset that this specific syndrome is coming into the limelight due to a possible COVID link. BlackholeWA (talk) 23:20, 13 May 2020 (UTC)[reply]

People keep editing the article, which had been stable and accurate. The most salient factor of the syndrome is its appearance during the height of the COVID-19 epidemic, and its possible link to COVID-19. I have put that back now. The original RCP pdf is outdated and had a small cohort. Softlavender (talk) 04:54, 14 May 2020 (UTC)[reply]

Need to follow reliable medical sourcing

@Softlavender: The problem is, that in this new, fast-moving clinical context, we find ourselves needing to provide - briefly, at least - some reliable medical information to the general public with little current availability of Wikipedia's reliable medical sourcing (WP:MEDRS), except for the RCPCH Guidance document [1]: this to be a *current* set of clinical practice guidelines (per WP:MEDRS#Summarize scientific consensus). The Children's Hospital Los Angeles information sheet for parents [2] also seems to me a useful source (or maybe External Link?). At present, the definition is inappropriately sourced to a newspaper article (clearly *not* a MEDRS).

Normal Wikipedia Medicine practice for providing emerging clinical information is to refer to available MEDRS, while awaiting greater availability of potential MEDRS.

At present, primary (i.e. non-MEDRS) studies are starting to emerge, such as this small, hospital-based cohort study in The Lancet (yet to be indexed by PubMed; the authors don't refer to the 'PMIS' nomenclature). Fwiw - Given the relative rarity of these conditions, such cohorts are bound to be small, and larger numbers may have to await availability of the sort of systematically conducted review articles which would be potential MEDRS.

Heads-up posted at WT:MED#Paediatric multisystem inflammatory syndrome. 86.134.212.26 (talk) 10:29, 14 May 2020 (UTC)[reply]

Moved primary source

Dallan C, Romano F, Siebert JN, et al. (2020). "Septic shock presentation in adolescents with COVID-19". Lancet Child Adolesc Health. doi:10.1016/S2352-4642(20)30164-4.

(trimmed because redundant, as cited.)

86.134.212.26 (talk) 15:15, 20 May 2020 (UTC)[reply]

PMIS or PIMS

Is it paediatric multisystem inflammatory syndrome (PMIS) or paediatric inflammatory multisystem syndrome (PIMS)? Gaia Octavia Agrippa ^Talk 21:47, 14 May 2020 (UTC)[reply]

@User:Gaia Octavia Agrippa I'm rather hoping this inflammatory anagrammatic multiterm disorder syndrome (IAMDiS) is now adequately addressed in the infobox. Certainly has me confused. 86.134.212.26 (talk) 17:05, 19 May 2020 (UTC)[reply]

Moved diagnostic information

Better, imo, to integrate the following clinical information into sentence/s sourced with available MEDRS (e.g. guidance / recommendations from RCPHC / CDC, etc):

Diagnostic signs in a blood test include markers of inflammation and coronary artery disease including high levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, N-terminal prohormone of brain natriuretic peptide (BNPT), procalcitonin, troponin and triglycerides.^[1]

^ Tara Haelle (8 May 2020), "Novel inflammatory syndrome in children possibly linked to COVID-19", Pediatric News

86.134.212.26 (talk) 14:31, 15 May 2020 (UTC)[reply]

86.134.212.26 I recall that sentence in an earlier version of the article, and the problem with that sentence is that some of the details conflict with what's in the RCPHC guidelines. On page 4, the lab findings are separated into 2 lists, one for findings that are in all patients and one for findings that are in some patients. That prior sentence isn't precise in that regard. The revised sentence sourced to the guidelines incorporates only the common findings:

Other laboratory findings supporting the diagnosis include abnormal fibrinogen levels; low albumin and lymphocyte count; and elevated levels of C-reactive protein (CRP), D-dimers, and ferritin.

Does this clarify? Moksha88 (talk) 01:06, 16 May 2020 (UTC)[reply]

Thanks Moksha88. No problem :-) 86.134.212.26 (talk) 23:07, 16 May 2020 (UTC)[reply]

un/usual suspects?

@Moksha88 If you (or anyone else here :-) happened to spot any other significant blunders in passing, that could be really useful. Many thanks anyway! 86.134.212.26 (talk) 15:00, 19 May 2020 (UTC)[reply]

ongoing news

Moved from == Epidemiology == (not an appropriate place for ongoing news items):

New York City regularly provides updates. As of 17 May, Mayor Bill de Blasio reports of 137 cases of pediatric multi-system inflammatory syndrome.^[1]. As of June 5, the State Department of Health of New York City reports 200 cases among them three deaths^[2]. Of these cases 94 percent tested positive for COVID-19 either by diagnostic, antibody testing or both.^[3]

There are over 20 US states reporting cases^[4]. Among them Michigan (23 cases)^[5]; Washington D.C. (23 cases)^[6]; Georgia (20 cases)^[7]; New Jersey (11 cases)^[8]; Illinois (10 cases)^[9]; Massachusetts (9 cases)^[10]; Connecticut (5 cases)^[11]; Maryland (4 cases)^[12]; Kentucky (4 cases)^[13]; Oregon (1 case)^[14]; Indiana (1 case)^[15]; Iowa (2 cases)^[16]; California (4 cases)^[17]; Texas (4 cases)^[18]; Colorado (3 cases)^[19]; Delaware (3 cases)^[20]; Pennsylvania (2 cases)^[21]; Florida (2 cases)^[22]; Washington (1 case)^[23]; Louisiana (1 case)^[24]; Utah (1 case)^[25]; New Hempshire (1 case)^[26]; Mississippi (1 case)^[27]; Virginia (1 case)^[28]. — Preceding unsigned comment added by 77.58.119.120 (talk) 23:33, 18 May 2020 (UTC)[reply]

A couple of further countries have reported new cases. Among them are: South Korea^[29], India^[30]^[31], — Preceding unsigned comment added by 178.192.164.89 (talk) 11:56, 3 June 2020 (UTC)[reply]

Thank you - that's helpful :-) — Preceding unsigned comment added by 86.134.212.26 (talk) 16:54, 19 May 2020 (UTC)[reply]

It seems main problem are coronary artery abnormalities aka damage of heart [3]. My very best wishes (talk) 03:27, 20 May 2020 (UTC)[reply]
- Thank you My very best wishes. Unsurprisingly perhaps, given that coronary artery aneurysms (surprisingly short page) are a major long-term complication of Kawasaki disease [4]. I'll try to help see this aspect more clearly covered in the medical part of the page. 86.134.212.26 (talk) 07:25, 20 May 2020 (UTC)[reply]

86.134.212.26 (talk) 16:42, 18 May 2020 (UTC)[reply]

moved content

@User:Doricke: The content added here is sourced to a (possibly still not peer-reviewed) hypothesis-type paper which does not comply with WP:MEDRS:

A novel hypothesis that Kawasaki disease is caused by dysregulated activation of mast cells by Fc receptor-bound pathogen antibodies accounts for much of the pathology of this disease^[1]. Histamine release from mast cells induces contraction of pericyte or effector cells on cardiac capillaries impeding blood flow^[1]. Back pressure from capilaries occulsions induces coronary aneurysms in some patients^[1]. Other Kawasaki disease symptoms can be linked to increased histamine levels.
...
It has been suggested that, as with Kawasaki disease, one possible mechanism is antibody-dependent enhancement, whereby development of antibodies facilitates viral entry into host cells^[2] or by release of histamine from mast cells activated by Fc receptor-bound SARS-CoV-2 antibodies^[1]. Ricke et al.^[1] proposes that MIS-C is occuring in patients with subsequent SARS-CoV-2 infections or infants with maternally transferred SARS-CoV-2 antibodies.

^ ^a ^b ^c ^d ^e "Kawasaki Disease, Multisystem Inflammatory Syndrome in Children: Antibody-Induced Mast Cell Activation Hypothesis" (PDF). MIT Lincoln Laboraotry. 11 June 2020 (PDF). {{cite web}}: Check |archiveurl= value (help)
^ "Rapid risk assessment: Paediatric inflammatory multisystem syndrome and SARS-CoV-2 infection in children". European Centre for Disease Prevention and Control. 15 May 2020. Archived from the original (PDF) on 15 May 2020.

86.186.155.159 (talk) 08:44, 12 June 2020 (UTC)[reply]

Only up to age 19 or 21?

According to the article, this disease only occurs up to age 19 or 21. However, it's currently big news in Israel that a 26-year-old died of it (see https://m.jpost.com/israel-news/26-year-old-man-becomes-youngest-victim-of-the-coronavirus-in-israel-631475 for an English source). 147.161.15.98 (talk) 07:21, 15 June 2020 (UTC)[reply]

Thank you for the heads up. According to the Times of Israel [5],
Doctors around the world treating COVID-19 patients have in the past warned of a rare inflammatory condition that can seriously harm children with the disease. It was not clear from the initial reports if that [i.e. the subject of this page] was the ailment that Asulin developed.
In time, this case will obviously be reported and considered in the scientific literature (and Kawasaki disease has very occasionally been reported in adults [6]).
Regarding your question, the arbitrariness of the 19 and 21 year cut-offs presumably stems from the emerging character of the disease, and the practical need to direct clinicians' attention to certain age groups. Our task here, per WP:MEDRS, is to report information from the most reliable sourcing currently available, such as official practice guidelines and consensus statements, etc.
86.186.155.159 (talk) 09:00, 15 June 2020 (UTC)[reply]

From the news sites here in Israel, the question appears to be not whether or not he had it, but whether medical malpractice caused his death. 147.161.13.64 (talk) 16:31, 16 June 2020 (UTC)[reply]

From a strictly editorial point of view regarding this particular disease page, the *historical* significance of the case (if it is actually confirmed as being Kawasaki-like and COVID-related, as seems likely) could be - in addition to the adult age - that it's the first case recorded outside Europe/USA. On reflection though, I feel it's probably best to wait for clinical confirmation to avoid speculative content here. 86.186.155.159 (talk) 16:48, 16 June 2020 (UTC)[reply]

Thank you

Now inserted here. That was a really helpful heads up - thank you! 86.186.155.159 (talk) 11:41, 11 July 2020 (UTC)[reply]

unofficial draft guidelines

Broadly in the spirit of WP:MEDRS, I think, moving an independent/unofficial set of draft clinical guidelines from == Treatment== (while maintaining the ref elsewhere to source some currently recognized symptoms):

A proposed set of COVID-19 guidelines for paediatric intensive care units (with different levels of resources) has been drafted by an international team of experts.^[1]

^ Kache S, Chisti MJ, Gumbo F, et al. (July 2020). "COVID-19 PICU guidelines: for high- and limited-resource settings". Pediatric Research. doi:10.1038/s41390-020-1053-9. PMID 32634818.

MEDMOS changes

@Ozzie10aaaa: This rejigging of sections may follow the letter of MEDMOS. However, as the main contributor to this page (and its structure) I feel the need to say that, for this particular *novel* diagnosis, I don't see it makes for improved communication with our general readership. I believe that a significant proportion of users might conceivably find it more intuitive to come to the novel * == Diagnosis == * etc without encountering the hurdle of epidemiological and pathogenetic technicalities in == Causes == / == Mechanism == . 86.186.155.159 (talk) 17:46, 23 July 2020 (UTC)[reply]

upon further review, you may have a point, please revert where you feel appropriate, thanks--Ozzie10aaaa (talk) 17:53, 23 July 2020 (UTC)[reply]

Thank you Ozzie10aaaa. (In this case, I think == Diagnosis == provides essential info to explain what the condition is, following on here from == Characteristics ===.) 86.186.155.159 (talk) 18:12, 23 July 2020 (UTC)[reply]

[PN-1] Tara Haelle (8 May 2020), "Novel inflammatory syndrome in children possibly linked to COVID-19", Pediatric News

[2] "Cuomo Urges More New Yorkers to Get Tested for Coronavirus". The New York Times. 17 May 2020. Archived from the original on 18 May 2020. Retrieved 18 May 2020.

[3] ttps://coronavirus.health.ny.gov/childhood-inflammatory-disease-related-covid-19

[4] ttps://coronavirus.health.ny.gov/childhood-inflammatory-disease-related-covid-19

[5] ttps://abcnews.go.com/Health/200-cases-doctors-warn-reports-rare-coronavirus-linked/story?id=70703314

[6] ttps://www.nbcwashington.com/news/local/23-dc-area-children-have-rare-illness-possibly-linked-to-covid-19/2308394/

[7] ttps://www.newsbreak.com/district-of-columbia/washington/news/0P6e6BHT/childrens-national-reports-23-cases-of-pediatric-inflammatory-illness-linked-to-covid-19/

[8] ttps://www.wsbtv.com/news/2-investigates/hospitals-ga-starting-see-suspected-cases-inflammatory-disease-kids-tied-covid-19/VYBJ5WWH4FAQDOGL4NBSJULKJQ/

[9] ttps://www.nbcnewyork.com/news/local/cdc-confirms-link-of-inflammatory-syndrome-in-children-to-covid-19-145-potential-cases-in-nyc/2421547/

[10] ttps://nbc25news.com/news/coronavirus/illinois-task-force-studying-mysterious-coronavirus-related-illness-in-children

[11] ttps://www.boston25news.com/news/health/cases-coronavirus-like-syndrome-affecting-children-mass/VDKLOXLUPJANXJOCRHKQDSE4H4/

[12] ttps://abc7ny.com/health/ct-death-toll-hits-3041-hospitalizations-continue-to-decrease/5991616/

[13] ttps://www.newsbreak.com/news/0P60T2uO/maryland-reports-4-cases-of-multisystem-inflammatory-syndrome-in-children-linked-to-covid-19-one-teen-dies-from-illness

[14] ttps://www.wkyt.com/content/news/What-are-the-symptoms-of-the-inflammatory-syndrome-affecting-children-570598211.html

[15] ttps://www.foxnews.com/health/first-cases-of-possible-coronavirus-linked-inflammatory-condition-children-mississippi-oregon

[16] ttps://www.wthitv.com/content/news/Indiana-reports-its-first-case-of-MIS-C-a-virus-linked-to-COVID-19-that-impacts-children-570569591.html

[17] ttps://www.weareiowa.com/article/news/local/iowa-mother-explains-her-sons-deadly-symptoms-after-getting-kawasaki-syndrome-multisystem-inflammatory-syndrome-misc-covid-19-coronavirus/524-aa2a8684-d1c1-47ae-9720-83df5a19fe3e

[18] ttps://www.foxla.com/news/4-children-in-la-county-diagnosed-with-rare-inflammatory-condition-linked-with-covid-19

[19] ttps://www.nbcdfw.com/news/health/local-children-develop-mysterious-syndrome-linked-to-covid-19/2372633/

[20] ttps://www.9news.com/article/news/local/local-politics/jared-polis-news-conference-watch-live/73-25ad5724-b9cd-45d0-b5be-00bcd52d23ca

[21] ttps://delawarebusinesstimes.com/news/covid-19-daily-briefing-5-19/

[22] ttps://www.collegian.psu.edu/news/coronavirus/article_6e792988-9b98-11ea-b67f-e3d5de7a2fc3.html

[23] ttps://miami.cbslocal.com/2020/05/18/2-children-icu-inflammatory-illness-linked-covid-19/

[24] ttps://kuow.org/stories/seattle-s-first-confirmed-case-of-rare-childhood-disease-linked-to-covid-19?fbclid=IwAR1NYm4pNQ9-lHVOV-048W2VuMsBrYGeE6QqGI_jnA6rgx4CiFjfyZb-asM

[25] ttps://www.foxnews.com/health/louisiana-girl-coronavirus-rare-inflammatory-condition-stopped-heart

[26] ttps://ksltv.com/438010/utah-child-shows-signs-of-pediatric-multi-system-inflammatory-syndrome/

[27] ttps://www.sentinelsource.com/news/local/nh-sees-first-case-of-inflammatory-syndrome-with-possible-covid-19-link/article_619c231d-d3b8-51e1-9ad4-64bddb18c495.html

[28] ttps://www.sunherald.com/news/coronavirus/article242847186.html

[29] ttps://www.wric.com/news/virginia-news/virginias-top-health-official-confirms-states-first-case-of-coronavirus-related-syndrome-in-children/

[30] ttps://wtvbam.com/news/articles/2020/jun/03/south-korea-says-kids-with-suspected-covid-19-syndrome-had-another-disease/1025031/?refer-section=world

[31] ttps://www.indiatvnews.com/fyi/mysterious-rare-disease-linked-to-covid-19-infecting-children-worldwide-are-indian-kids-vulnerable-618111

[32] ttps://www.latestly.com/india/news/kawasaki-syndrome-in-india-tamil-nadu-boy-countrys-first-case-of-this-covid-19-linked-illness-in-children-1768477.html

[Ricke2020-33] "Kawasaki Disease, Multisystem Inflammatory Syndrome in Children: Antibody-Induced Mast Cell Activation Hypothesis" (PDF). MIT Lincoln Laboraotry. 11 June 2020 (PDF). {{cite web}}: Check |archiveurl= value (help)

[ECDC-2020-34] "Rapid risk assessment: Paediatric inflammatory multisystem syndrome and SARS-CoV-2 infection in children". European Centre for Disease Prevention and Control. 15 May 2020. Archived from the original (PDF) on 15 May 2020.

[PICU2020-35] Kache S, Chisti MJ, Gumbo F, et al. (July 2020). "COVID-19 PICU guidelines: for high- and limited-resource settings". Pediatric Research. doi:10.1038/s41390-020-1053-9. PMID 32634818.

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@@ Line 78: / Line 78: @@
 @[[User:Ozzie10aaaa|Ozzie10aaaa]]: [https://en.wikipedia.org/w/index.php?title=Paediatric_multisystem_inflammatory_syndrome&type=revision&diff=969123940&oldid=969091213 This] rejigging of sections may follow the letter of MEDMOS. However, as the main contributor to this page (and its structure) I feel the need to say that, for this particular *novel* diagnosis, I don't see it makes for improved communication with our general readership. I believe that a significant proportion of users might conceivably find it more intuitive to come to the novel * == Diagnosis == * etc without encountering the hurdle of epidemiological and pathogenetic technicalities in == Causes == / == Mechanism == . [[Special:Contributions/86.186.155.159|86.186.155.159]] ([[User talk:86.186.155.159|talk]]) 17:46, 23 July 2020 (UTC)
 :upon further review, you may have a point, please revert where you feel appropriate, thanks--[[User:Ozzie10aaaa|Ozzie10aaaa]] ([[User talk:Ozzie10aaaa|talk]]) 17:53, 23 July 2020 (UTC)
-::Thank you [[User:Ozzie10aaaa|Ozzie10aaaa]]. [[Special:Contributions/86.186.155.159|86.186.155.159]] ([[User talk:86.186.155.159|talk]]) 18:12, 23 July 2020 (UTC)
+::Thank you [[User:Ozzie10aaaa|Ozzie10aaaa]]. (In this case, I think == Diagnosis == provides essential info to explain what the condition is, following on here from == Characteristics ===.) [[Special:Contributions/86.186.155.159|86.186.155.159]] ([[User talk:86.186.155.159|talk]]) 18:12, 23 July 2020 (UTC)