Pediatric Chronic Inflammatory Response Syndrome

While the same symptoms and objective laboratory tests are used to diagnose CIRS (chronic inflammatory response syndrome) in adults and children, there are differences in the diagnostic criteria used. The pathophysiology is thought to be the same at all age groups, and treatments differ slightly, but faster and more complete recovery is expected in children. Cytokine storms are seen in CIRS, in sepsis and COVID-19, and in their sequelae of post-sepsis syndrome and post-COVID syndrome. Transcriptomic changes in the latter group are similar to those of untreated CIRS patients. Overlaps are also seen in chronic fatigue syndrome, pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) patients. The prevalence of pediatric CIRS patients has been reported to be at least 7.01% and 7.6%, and it is likely higher in both children and adults. CIRS should be high on the differential for children with chronic headaches and/or abdominal issues. Fetal intrauterine exposure in water-damaged buildings may adversely affect brain development and may contribute to autism spectrum diagnoses. Pediatric CIRS is a preventable disorder, and even a preventable epidemic of medically unexplained symptoms; efforts should be made to protect children from this illness. Such measures will benefit the health of adults downstream.