Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
Chetan Sharma, Madhusudan Ganigara, Caroline Galeotti, Joseph Burns, Fernando M Berganza, Denise A Hayes, Davinder Singh-Grewal, Suman Bharath, Sujata Sajjan, Jagadeesh Bayry, Chetan Sharma, Madhusudan Ganigara, Caroline Galeotti, Joseph Burns, Fernando M Berganza, Denise A Hayes, Davinder Singh-Grewal, Suman Bharath, Sujata Sajjan, Jagadeesh Bayry
Abstract
Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4+ T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm.
Conflict of interest statement
The authors declare no competing interests.
© 2021. Springer Nature Limited.
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References
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Source: PubMed