Evidence mapPaperPMID 41519951Full record

ArticlePediatric research2026

Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome.

Osman Oguz Demir, Kubra Aykac, Arthur Hoi Hin Cheng, Selman Kesici, H Hakan Aykan, Yelda Bilginer, Ali Bulent Cengiz, Rae S M Yeung, Yasemin Ozsurekci, Seza Ozen

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Osman Oguz DemirDepartment of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Kubra AykacDepartment of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Arthur Hoi Hin ChengCell Biology Research Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
Selman KesiciDepartment of Pediatric Intensive Care, Hacettepe University Faculty of Medicine, Ankara, Turkey.
H Hakan AykanDepartment of Pediatric Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Yelda BilginerDepartment of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Ali Bulent CengizDepartment of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Rae S M YeungCell Biology Research Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
Yasemin OzsurekciDepartment of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Seza OzenDepartment of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey. sezaozen@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory condition with multi-organ involvement, particularly affecting the cardiac and gastrointestinal systems. Although immunomodulatory therapy is standard, treatment approaches vary. This study aimed to evaluate treatment modalities in MIS-C such as methylprednisolone (MP), intravenous immunoglobulin (IVIG), anakinra and therapeutic plasma exchange (TPE) based on clinical severity and laboratory parameters in a prospectively followed cohort.

methodsA total of 125 MIS-C patients were included in the study and followed for at least 6 months after discharge. Patients were stratified by severity and treated with various immunomodulatory regimens, including IVIG+MP, IVIG+MP+anakinra, and IVIG+MP+anakinra+TPE.

resultsPatients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20-24 mg/dL, ferritin 308-846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper.

conclusionThe mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration. IMPACT: Demonstrates that short-term, biomarker-guided use of anakinra and corticosteroids effectively controls hyperinflammation in MIS-C. Highlights that prolonged corticosteroid therapy may not be necessary, even in severe cases. Provides evidence of early cardiac recovery, including resolution of CAAs, without post-discharge steroids. Supports a steroid-sparing treatment approach, reducing risks of long-term immunosuppression. May inform future MIS-C treatment guidelines by minimizing the need for escalation therapy, ECMO, and related complications.

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PMID41519951

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