NOMID and COVID multisystem inflammatory disease

Can there be a relationship to the coronavirus-19 (COVID-19) that affects young children? People are talking about it. It’s called NOMID or Neonatal onset multisystem inflammatory disease. Other than both being inflammatory diseases. Are they siblings or distant cousins? They may not be in the same family! What’s the link?

It’s rare. As we immerse ourselves at coronavirus prevention, a disease emerged that affects kids from 2-15. Neonatal-onset multisystem inflammatory disease is a rare genetic periodic fever syndrome which causes uncontrolled inflammation in multiple parts of the body starting in the newborn period. Symptoms include skin rashes, severe arthritis, and chronic meningitis leading to neurologic damage. It’s there since birth but symptoms can show anytime. Is YOUR child safe from multisystem inflammatory disease?

Neonatal onset multisystem inflammatory disease (NOMID) is a disorder that causes persistent inflammation and tissue damage primarily affecting the nervous system, skin, and joints. Recurrent episodes of mild fever may also occur in this disorder. People with NOMID have a skin rash that is usually present from birth.

NOMID is also known as chronic infantile neurologic cutaneous articular (CINCA) syndrome. As a syndrome, it encompasses many neurological diseases and symptoms. While NOMID is a very rare disorder. Only about 100 affected individuals with different ethnic backgrounds have been widely reported. Males and females are equally affected. Yet, within the coronavirus pandemic. NOMID tips the scales to focus on children’s susceptibilities. Some believe there are genetic mutations, much like DDX3, Muscular Dystrophy, and Multiple Sclerosis…among many.

While there are some standard therapies and some under investigation, NOMID
has no cures, much like other diseases from genetic mutations.

NOMID is an American term for CINCA. Statistics of possible CINCA prevalence has been done elsewhere. The exact prevalence of chronic infantile neurological, cutaneous, and articular (CINCA) syndrome is unknown, it is estimated that the whole spectrum of CAPS has a prevalence of 1/360,000 in France, CINCA being the less common form. In the Eurofever registry, collecting information on over 250 patients with NLRP3 mutation, about 25% of the patients present the most severe CINCA phenotype.

Symptoms noted, may confuse parents and pediatricians:

Chronic aseptic meningitis

Progressive profound sensorineural hearing loss in >70%

Increased intracranial pressure

Papilledema – Papilledema is a serious medical condition where the optic nerve at the back of the eye becomes swollen. Symptoms can include visual disturbances, headaches, and nausea.

Headache

Ventriculomegaly – Ventriculomegaly, also known as hydrocephalus, is a condition in which the CSF-filled structures within the brain become larger than normal. As a result, the large ventricles can inhibit the proper development of the brain.

Cerebral atrophy

Seizures

Significant developmental delay

Where 3 or 4 symptoms are chronically present, genetic testing would be required. Advice is to see a pediatric neurologist.

Bringing NOMID/CINCA into the spotlight is that some therapies used seem to also work on COVID-19 patients. This is dissimilar as COVID-19 is viral and NOMID/CINCA is genetic. Whether this loose relationship is better for NOMID patients or COVID patients is like grasping at straws.

Parenting is difficult. Comparing NOMID to COVID-19 leads to overwhelming concerns. Both are actively still seeking treatmets, cures, vaccines. Symptomatically COVID is more respiratory and NOMID relates to irregular brain pressures. I don’t see how one relates to the other.