[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-444701-105":59,"doc-detail-444701-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","mis-c-diagnosis-management-and-outcomes","MIS-C: Diagnosis, Management, and Outcomes","","Multisystem inflammatory syndrome in children (MIS-C) is a post–COVID-19 hyperinflammatory disorder affecting pediatric patients, marked by persistent fever, shock, multisystem involvement, and possible severe cardiovascular disease. This review synthesizes evidence on epidemiology, pathophysiology, clinical features, diagnostic criteria, and differential diagnosis. Management emphasizes supportive care, hemodynamic stabilization, and targeted immunomodulation with IVIG, corticosteroids, and biologics, often combined with thromboprophylaxis and long-term follow-up for cardiac, gastrointestinal, and neurologic complications.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mis-c-diagnosis-management-and-outcomes/444701/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mis-c-diagnosis-management-and-outcomes/444701.png","ImageObject",300,407,{"name":92,"@type":93},"Bulrr","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is MIS-C and when does it typically occur after SARS-CoV-2 infection?","Question",{"text":113,"@type":114},"MIS-C is a delayed hyperinflammatory condition that typically develops 2 to 6 weeks after acute SARS-CoV-2 infection or exposure. It is characterized by fever, inflammation on laboratory testing, and multisystem involvement without another plausible diagnosis.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How is MIS-C diagnosed in clinical practice?",{"text":118,"@type":114},"Diagnosis requires fever over 38.0°C lasting more than 24 hours, along with elevated inflammatory markers such as C-reactive protein, ferritin, D-dimer, and erythrocyte sedimentation rate. Multisystem involvement (at least two organs) is also required.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the core treatment approaches for MIS-C?",{"text":122,"@type":114},"Management focuses on supportive care and hemodynamic stabilization, plus targeted immunomodulation. IVIG, corticosteroids, and biologics form the therapeutic cornerstone, and thromboprophylaxis is frequently warranted due to elevated thromboembolic risk.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},444701,1791180674,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41,"preview_page_count":4},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Open Forum Infectious Diseases  \nREVIEW ARTICLE  \nMIS-C: Diagnosis, Management, and Outcomes  \nChristophe El Rassi,1,a, Roy El Darzi,1,a, Maria Abou Mansour,1, and Mariam Arabi1,2,  \n1Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon, and 2Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon  \nMultisystem inflammatory syndrome in children (MIS-C) is an emergent postinfectious hyperinflammatory disorder predominantly affecting the pediatric population following COVID-19 infection. Clinically, it is characterized by persistent fever, shock, multiorgan involvement, and potentially severe cardiovascular involvement. This comprehensive review synthesizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic criteria, with particular emphasis on the management of MIS-C. We also stress on the importance of distinguishing MIS-C from phenotypically similar entities. Acute-phase management centers on supportive care, hemodynamic stabilization, and targeted immunomodulation, with intravenous immunoglobulin, corticosteroids, and biologic forming the therapeutic cornerstone. Thromboprophylaxis is frequently warranted due to the elevated thromboembolic risk, and long-term follow-up is essential to monitor for cardiac, gastrointestinal, and neurologic complications. Additional considerations include postrecovery vaccination protocols and the use of extracorporeal membrane oxygenation in cases of refractory cardiorespiratory failure. Despite advancements in clinical  \noutcomes, diagnostic ambiguity and heterogeneous management guidelines continue to pose significant challenges. Keywords. COVID-19; immunomodulatory; MIS-C; therapy.  \nIn 2020, amidst the COVID-19 pandemic, multisystem inflammatory syndrome in children (MIS-C) emerged as a post-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) complication in the pediatric population [ 1, 2]. Initially termed PIMS-TS (pediatric MIS, temporally associated with COVID-19), it was then labeled by the Centers for Disease Control and Prevention (CDC) as MIS-C [3, 4] . Multiple definitions for MIS-C were proposed by different organizations such as the CDC [5] and Royal College of Pediatrics and Child Health (RCPCH) [6], which all included fever, involvement ofat least one organ system, and inflammation as typical diagnostic findings in a child previously infected with SARS-CoV-2 . While the mortality of COVID-19 was reported to not exceed 0.2 per 100,000 population that of MIS-C ranges between 1 and 2 per 100 cases [7–9] . This highlights the importance of proper management of MIS-C. This disease also presented itself as having many clinical similarities to other inflammatory conditions such as Kawasaki disease (KD), culture negative sepsis, and microbial infections like rickettsiosis or typhoid fever [ 10–13] . The first cases of MIS-C reported in  \nReceived 21 July 2025; accepted 25 November 2025; published online 19 December 2025 aThese two authors contributed equally to the work.  \nCorrespondence: Mariam Arabi, MD, Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Riad El Solh Street, Beirut 1107 2020, Lebanon ([ma81@aub.edu.lb](ma81@aub.edu.lb)) .  \nOpen Forum Infectious Diseases®  \n© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.  \n[https://doi.org/10.1093/ofid/ofaf762](https://doi.org/10.1093/ofid/ofaf762)  \nthe literature consisting of 8 children and adolescents presenting with a hyperinflammatory syndrome in April 2020, ","cbCaiqbGTDYvnHaV","https://ap.wps.com/l/cbCaiqbGTDYvnHaV","pdf",517161,12,"English","# MIS-C: Diagnosis, Management, and Outcomes\n## Background, Definition, and Epidemiology\n## Pathophysiology and Diagnostic Criteria\n## Differential Diagnosis and Clinical Similarities\n## Management Strategies and Immunomodulation\n## Thromboprophylaxis, Follow-up, and Special Considerations","[{\"question\":\"What is MIS-C and when does it typically occur after SARS-CoV-2 infection?\",\"answer\":\"MIS-C is a delayed hyperinflammatory condition that typically develops 2 to 6 weeks after acute SARS-CoV-2 infection or exposure. It is characterized by fever, inflammation on laboratory testing, and multisystem involvement without another plausible diagnosis.\"},{\"question\":\"How is MIS-C diagnosed in clinical practice?\",\"answer\":\"Diagnosis requires fever over 38.0°C lasting more than 24 hours, along with elevated inflammatory markers such as C-reactive protein, ferritin, D-dimer, and erythrocyte sedimentation rate. Multisystem involvement (at least two organs) is also required.\"},{\"question\":\"What are the core treatment approaches for MIS-C?\",\"answer\":\"Management focuses on supportive care and hemodynamic stabilization, plus targeted immunomodulation. IVIG, corticosteroids, and biologics form the therapeutic cornerstone, and thromboprophylaxis is frequently warranted due to elevated thromboembolic risk.\"}]","MIS-C: Diagnosis, Management, and Outcomes | PDF",1790708941]