Abstract

Background: The first paper was published with a picture of hyperinflammatory shock, similar to atypical Kawasaki disease, and Kawasaki disease shock syndrome in the coronavirus disease-2019 (COVID-19) pandemic released in Europe, which was the starting point. Nevertheless, the multisystem inflammatory syndrome in children (MIS-C) defined by the Center for Disease Control and Prevention in late April put the points on the board to diagnose one of the late reactions of severe acute respiratory syndrome coronavirus-2 infection in children.
Case Presentation: We are reporting an 11-year-old boy known to have diabetes mellitus type 1 presented with MIS-C picture in the form of fever, vomiting, abdominal pain, the eruption of maculopapular skin rash all over his body, erythematous cracked lips, and bilateral non-purulent conjunctivitis in Saudi Arabia. This diagnosis can be missed easily due to underestimating the risk and severity of COVID-19 in the children's age group. Although the ketoacidosis was a concern in COVID-19 patients shown in some of the literature, it is still very much challenging to expect the course of such a new disease.
Conclusion: The presence of Kawasaki-like signs in COVID-19 patients should be an alarming point to consider MIS-C, a syndrome with extensive organ involvement and yet indistinct exact pathophysiology ketoacidosis and hyperglycemia. They deserve more research to reach a sector guide in the relationship between the COVID-19 and these new phenomena in such cases.

Key words: Kawasaki disease shock syndrome, COVID 19, Multisystem Inflammatory Syndrome in children, DM Type I