case_images: PMC11757169_01
case_images: Clinical manifestation, essential laboratory findings, and key management of the patient. MIS-N, multisystem inflammatory syndrome in neonates; PPHN, persistent pulmonary hypertension of the newborn; PTA, percutaneous transluminal angioplasty; CRP, C-reactive protein; IVIG, intravenous immunoglobulin.
case_images: fped-12-1474192-g001.jpg
case_images: PMC11757169_01_fped-12-1474192-g001.jpg
case_images: F1
case_images: MIS-N was made after the patient met the clinical and laboratory criteria (Table 1). MIS-N treatment was initiated with intravenous immunoglobulin (IVIG) and high-dose methylprednisolone, as shown in Figure 1. The hematology team was consulted and enoxaparin was initiated (Figure 1).
case_images: (A1) CTA abdominal aorta showing right renal artery stenosis and arterial thrombus in the juxta-renal abdominal aorta and left IIA. (A2) Angiography showing thrombus resolution at 3-week follow-up. (B1) Echocardiography at DOL 8 showing a new left coronary artery aneurysm. (B2) Echocardiography at age of 7 months showing regression of the coronary artery aneurysm to normal.
case_images: fped-12-1474192-g002.jpg
case_images: PMC11757169_01_fped-12-1474192-g002.jpg
case_images: F2
case_images: To confirm the presence of the suspected renovascular disease, computed tomography angiography (CTA) was performed, which showed a narrowing of the proximal right renal artery and a filling defect in the juxta-renal abdominal aorta and left internal iliac artery suggestive of thrombosis with delayed flow in the left internal iliac artery (Figure 2).