# Case Report: MIS-C precipitating DKA and renal failure in a morbidly obese male with type 2 diabetes mellitus

## TL;DR

A 15-year-old obese male with type 2 diabetes developed MIS-C, which was initially masked by diabetic ketoacidosis and kidney failure.

## Contribution

This case highlights the risk of MIS-C in obese children and its variable presentation alongside endocrinologic complications.

## Key findings

- MIS-C diagnosis was complicated by concurrent DKA and renal failure in a morbidly obese adolescent.
- The case underscores the increased risk of MIS-C in obese children with diabetes.
- Endocrinologic complications are a notable feature of MIS-C.

## Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a recently described systemic inflammatory sequelae of SARS-CoV-2 infection. Diagnostic criteria for MIS-C includes age <21, fever (>38°C), laboratory evidence of inflammation, clinically severe illness requiring hospitalization with multisystem (≥2) organ involvement, Evidence of current or recent SARS-CoV-2 infection or exposure, and has no alternative explanation for their symptoms. We present a 15-year-old, morbidly obese male whose diagnosis of MIS-C was obfuscated by diabetic ketoacidosis (DKA). This case highlights the increased risk of development of MIS-C in obese children, variability of presentation, and contributes to the body of research demonstrating endocrinologic complications of MIS-C.