Atypical and incomplete PIMS-TS
This is an important, but so far unanswered question which will require further investigation. PIMS-TS, when it first emerged, was compared to Kawasaki Disease. Kawasaki Disease can present in classical, atypical and incomplete forms. If cases are not identified because they are milder, or don’t fulfil the full criteria, they might not receive appropriate treatment in the appropriate time frame. This could result in hidden damage to organs or arteries.
If you think your child may have had PIMS-TS in the past and not been diagnosed, follow this link for advice and information, and/or seek advice from your GP.
Ensuring 100% case ascertainment was not possible and therefore the numbers might be an underestimate of PICU admissions. The selection of conditions covered by the PICANet search might not have covered all inflammatory conditions, and it is likely that a small number of patients with undiagnosed multisystem inflammatory illnesses were not included in our PICANet search. Moreover, it is likely that a large population of affected patients did not need critical care admission and we might be underestimating the true incidence of PIMS-TS in the hospital population… this limitation has implications for those patients who were not unwell enough to be admitted to the intensive care unit. We advise caution and close follow-up for all patients diagnosed with PIMS-TS.
Source: Lancet study on PIMS-TS ICU admissions April-May 2020
It is likely that these (cases that did not meet the case definition) were milder cases along the PIMS-TS spectrum, which needs to be taken into account in future case definitions…..mild cases and those that were not hospitalised or had short hospital stays, may therefore be missed
Source: BPSU Study Part 1