- Kawasaki Disease as the Immune-Mediated Echo of a Viral Infection

Rigante, Donato

doi:10.4084/mjhid.2020.039

Cited by 20 publications

(24 citation statements)

References 58 publications

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“… 18 , 20 , 21 KD has been related to the occurrence of different viral infections in children, but that its direct, unequivocal cause is still unclear. 22 Evidence for IVIG and glucocorticoids in MIS-C is also based on their use in KD and fulminant myocarditis, two conditions that resemble MIS-C in some aspects. 23 There is no consensus for the treatment of severe MIS-C in our country.…”

Section: Discussionmentioning

confidence: 99%

First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

Borgi

Khadhraoui

Louati

et al. 2021

Mediterr J Hematol Infect Dis

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Background: Multisystem inflammatory syndrome in children (MIS-C) is a new serious emerging disease that is temporally related to previous exposure to coronavirus infection disease (COVID-19). Aim: To describe the clinical features, laboratory findings, therapies and outcomes for the first Tunisian cluster admissions of critically ill children with severe MIS-C. Methods: Retrospective study conducted between 01 November and 30 November 2020 We included 8 children aged less than 15 years who were admitted to our pediatric intensive care and met the criteria for MIS-C according to the WHO definition case. We reviewed the medical records of all patients to collect demographic and clinical data, severity scores, laboratory test results, echocardiographic findings, treatment, and outcomes. Results: All children were previously fit and well. Seven patients were boys. Known exposure to COVID-19 was reported in 4 cases. Fever and gastrointestinal symptoms were reported in all cases. Five patients had marked abdominal pain and were examined by the surgeon for a possible appendicitis. Seven patients had diarrhea. On examination, we found a rash (n=7), a conjunctivitis (n=7), a cheilitis (n=5) and a meningism (n=3). We reported cardiac dysfunction in 7 cases and a shock with hypotension in 3 cases. All patients received immunoglobulins, methyl prednisolone and a low dose of aspirine. No deaths occurred. Conclusion: We reported here the first Tunisian cluster admissions of 8 critically ill children with MIS-C to highlight the increase of a new severe emerging disease with an evidence of prior COVID-19 infection in older children.

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Section: Discussionmentioning

confidence: 99%

First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

Borgi

Khadhraoui

Louati

et al. 2021

Mediterr J Hematol Infect Dis

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“…For almost 40 years, there have been several papers suggesting that viruses were involved with Kawasaki disease, and several viral candidates have been proposed [11]. One paper discusses the involvement of~20 viral pathogens, including Epstein-Barr virus, bocavirus, human coronavirus HCoV-NL63, human coronavirus HCoV-229E, human coronavirus SARS-CoV-2, influenza virus, adenovirus, human parvovirus B19, Torque teno virus, etc.…”

Section: What Pathogens Could Trigger Kawasaki Disease?mentioning

confidence: 99%

Potential New Treatments for Kawasaki Disease, Its Variations, and Multisystem Inflammatory Syndrome

Roe¹

2021

SN Compr. Clin. Med.

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The causation of Kawasaki disease has been a medical mystery for over 54 years. However, the causations of Kawasaki disease, its variations, and COVID-19-associated Multisystem Inflammatory Syndrome have been recently explained to involve high replication rate viral infections. In a subset of patients, the extensive antigen-antibody immune complexes that are not quickly cleared by phagocytosis will create a type III hypersensitivity immune reaction. The subsequent release of proteases and other enzymes and the expression or exposure of new immunogenic antigens due to protease attacks on basement membranes of epithelial cells or endothelial cells in blood vessels will induce new autoantibodies and cause Kawasaki disease, its variations, and COVID-19-related Multisystem Inflammatory Syndrome. There is now increasing evidence that a viral infection of a large surface area of tissue, such as the respiratory tract, gastrointestinal tract or blood vessels, and a resultant type III hypersensitivity immune reaction is the most plausible explanation for the causations of Kawasaki disease, its variations, and COVID-19-related Multisystem Inflammatory Syndrome. Furthermore, an improved understanding of these causations also suggests several potential new treatments which can be more effective.

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“…A number of theories have linked KD to bacteria, viruses and different environmental factors, but none has been proved. It is discussed if the trigger of KD might be an RNA virus that normally causes an asymptomatic infection in most children and KD in a subset of genetically predisposed children [ 7 ]. The most significant complications in KD are cardiovascular and prominently involve coronary arteries, though the overall incidence of coronary artery abnormalities (CAA) has been reduced by treatment with intravenous immunoglobulin (IVIG) given within 7–10 days after disease onset [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease

et al. 2021

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Aim of these revised recommendations for the general management of Kawasaki disease is to encourage its prompter recognition and warrant the most appropriate therapy, based on ascertained scientific data, raising awareness of the complications related to misdiagnosis or delayed treatment. A set of 20 synthetic operative statements is herein provided, including the definition of Kawasaki disease, its protean presentations, clinical course and seminal treatment modalities of all disease phases. The application of these recommendations should improve prognosis of Kawasaki disease and prevent the progression to permanent vascular abnormalities, thereby diminishing morbidity and mortality.

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- Kawasaki Disease as the Immune-Mediated Echo of a Viral Infection

Cited by 20 publications

References 58 publications

First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

Potential New Treatments for Kawasaki Disease, Its Variations, and Multisystem Inflammatory Syndrome

Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease

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