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    MIS-C Treatment: Is glucocorticoid monotherapy enough for mild cases?
    (W B saunders co-elsevier, 2024) Sütçü, Murat; Kara, Emine Manolya; Yıldız, Funda; Gül, Doruk; Yıldız, Raif; Yılmaz, Duygu; Atik, Fatih; Özkaya, Ozan
    Background: The effectiveness of using only glucocorticoids (GCs) in mild multisystem in flammatory syndrome (MIS-C) cases was compared with combined treatment [GCs + Intravenous immune globulin (IVIG)]. Methods: This retrospective cohort study was conducted between June 1, 2020, and June 1, 2022, in a tertiary care center in Istanbul, Turkey. Clinical and investigational data of the MIS-C patients were analyzed. The patients were divided into two groups: those who received only GCs and those who received the GCs + IVIG combination. The primary outcome focused on assessing the deterioration of the patient's clinical condition, the occurrence of shock, admission to the pediatric intensive care unit (PICU), and the need for additional immunosuppressive medication. Secondary outcomes included evaluating the course of cardiovascular and infection-related complications observed at the one-year follow-up. Results: Ninety-seven MIS-C patients with a median age of 41 (3 - 214) months were enrolled. Fifty-six (57.7%) patients were male. All the patients had fever at admission with a temperature of 39 degrees C (37.5 degrees C -40.1 degrees C). Thirty-two patients (33%) had cardiac findings on echocardiography [left ventricular dysfunction ( n = 13, 13.5%), coronary artery involvement ( n = 11, 11.3%), and dilation of cardiac cavities and/or increased cardiac muscle thickness ( n = 8, 8.2%)]. Thirteen patients (13.5%) required intensive care. All patients received GCs [only GCs (group I; n = 65, 67%)], and 32 patients (33%) with severe manifestations and/or cardiac involvement received GCs + IVIG (group II). No mortality was observed. None of the patients had any complaints at the oneyear follow-up, and all echocardiography findings were normal. Conclusion: This study provides preliminary evidence that GC monotherapy is a safe treatment alternative for mild MIS-C cases without cardiac involvement. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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    Rhabdomyolysis after BNT162b2 mRNA Covid-19 vaccine in an adolescent male
    (Malawi Medical Journal, 2022) Sütçü, Murat; Gül, Doruk; Atik, Fatih; Kara, Emine Manolya
    Pfizer-BioNTech COVID-19 (BNT162b2) conferred a high level of protection against Covid-19 with a proven short-term safety profile. Although cases of vaccine-associated myopericarditis have been reported, the existence of rhabdomyolysis without myocarditis has not yet been published. A 16-year-old, healthy male patient, who did not use any herbal or illegal drugs before, was admitted with muscle pain that developed after the second dose of BNT162b2 vaccine. Cardiac examination and heart enzymes were normal and the patient had significantly higher creatinine kinase levels. The patient, whose enzymes returned to normal with only force hydration therapy, recovered without complications. Reporting the side effects of the vaccine, which has a short history of application to large populations, is of vital importance in the conduct of vaccine development studies and in identifying the risky group in terms of side effects. © 2022 The College of Medicine and the Medical Association of Malawi.