Paediatric multisystem inflammatory syndrome

Paediatric multisystem inflammatory syndrome (called PIMS-TS or PIMS for short) is a rare condition thought to be triggered by COVID-19. Although it is a relatively new rare condition, we can detect it early and treat it successfully.

Our PIMS-TS service provides coordinated care at our hospital for the small number of children and young people with the condition. This page explains what the condition is, how it is treated and how you are cared for after you go home.

What is PIMS-TS

Paediatric multisystem inflammatory syndrome (called PIMS-TS or PIMS for short) is a new condition that can happen in some children and young people sometime after they have had COVID-19.

The condition is a delayed reaction to the body trying to overcome the virus, and this causes swelling throughout the body.

The symptoms of PIMS-TS are different to COVID-19, and many children who experience PIMS-TS may not have previously been unwell or had COVID-19 symptoms.

As world-leaders in medical research we were amongst the first in the world to report PIMS-TS as a new condition in April 2020. As the condition is new, there is work happening across the world to learn all we can about it. We have been working with other hospitals in London since it was identified to understand more about the condition, improve treatments, and take part in pioneering research to understand any longer-term impacts.

What are the symptoms?

Symptoms of PIMS-TS can include:

• a prolonged fever (higher than 38C)
• tummy ache
• diarrhoea and/or vomiting
• widespread red rash
• red bloodshot eyes, strawberry red tongue, or red cracked lips
• swelling of fingers and toes
• not feeling or acting like themselves. 

If your child has any of the following symptoms you should call your GP or call NHS 111 for advice. If your child develops chest pain, please call 999 immediately.

How is it treated?

The very small number of children who get PIMS-TS usually require hospital treatment as it is a serious condition. The children and young people we’ve seen with PIMS-TS have responded very well to the hospital treatment. We continue to monitor them through regular check-ups afterwards.

A combination of medicine is used to calm down your immune system that is causing the swelling in the body and making you unwell. This medicine includes:

• an intravenous (given through a drip) immunoglobulin (IVIG). This is a blood product that helps to fight the infection and reduce inflammation and the risk of swelling in the blood vessels of the heart.
• aspirin, taken by mouth, helps reduce the risk of blood clots. The aspirin needs to be continued for at least six weeks after discharge from hospital. Please ask your GP for a repeat prescription. If there are no problems with your child’s coronary arteries or heart function when they are seen six weeks after being in hospital, the aspirin can usually be stopped. This medication should be taken with food.
• steroids, such as IV methylprednisolone, which are given through a drip, and oral prednisolone are also available, if needed. This helps reduce the inflammation in the body. This medication should be taken with food.

• once you are well enough to go home, you will need to keep taking some medication at home, and come back to the hospital for some tests and check ups.