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

Symptoms of neck inflammation are a common sign of multisystem inflammatory syndrome in children, a serious condition associated with 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 between March 2020 and Jan. 20, 2021, at Children’s Healthcare of Atlanta.

Of the 137 patients with a diagnosis of 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 evidence of retropharyngeal edema/inflammation. All patients treated for retropharyngeal edema were aged 13 years 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 aged 4 years and older, “which is incongruent with the typical epidemiologic distribution of purulent retropharyngeal infection,” Jenkins and colleagues wrote.

They noted a recent study from the United Kingdom that included common reports of neck pain among patients with MIS-C, and a U.S. study in which neck pain was associated with higher odds of MIS-C than other febrile conditions.

“In conclusion, neck symptoms are a relatively frequent manifestation of MIS-C and could be considered a distinct clinical system associated with its diagnosis,” Jenkins and colleagues wrote.

References:

Carlin RF, et al. J Pediatr. 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.