Kawasaki disease mimickers

Abstract

Background Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic test, detailed clinical history and physical examination are still fundamental to make a diagnosis. Methods We present five representative cases with KD‐like presentations: systemic onset juvenile idiopathic arthritis, mycoplasma‐induced rash and mucositis, staphylococcal scalded skin syndrome, BCGosis, and the recently described multisystemic inflammatory syndrome in children (MIS‐C) associated with the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) virus. Results Rash, fever, and laboratory markers of inflammation can be present in several childhood diseases that may mimic KD. Conclusion The term ‘Kawasaki syndrome’ instead of ‘Kawasaki disease’ may be more appropriate. Physicians should consider an alternative diagnosis that may mimic KD, particularly considering MIS‐C during the present pandemic, as an aggressive diagnostic and therapeutic approach is needed.

COVID-19: why not learn from the past?

“…Similarly, the use of hyper-immune serum from recovered patients was indicated among the successful therapeutic interventions during the SARS outbreak [29] and was apparently rediscovered, as a new and innovative strategy, during the COVID-19 pandemic. Also the increased incidence of Kawasaki-like disease (or rather "syndrome" as this clinical presentation of the SARS-CoV-2 infection in children is now called), had been described during the SARS outbreak, and has occurred again during the COVID-19 pandemic [30], as should have been expected, given the much larger prevalence of the infection.…”

Virale Exantheme im Kindesalter

“…In einzelnen Fallberichten wurden weitere Hautmanifestationen beschrieben. So zeigte sich bei Patienten mit PIMS ebenso eine Purpura im Rahmen einer Ig(Immunglobulin)A-Vaskulitis [ 16 ], und in einem weiteren Fall wurden lokalisierte Hautexantheme im Genitalbereich und an den Füßen beschrieben [ 43 ].…”

“…Bei Auftreten von PIMS ist die SARS-CoV-2-PCR meist bereits negativ und die Serologie positiv für SARS-CoV-2-Antikörper. Im Routinelabor zeigen sich die Entzündungsparameter (CRP, BSG, Ferritin) stark erhöht sowie eine Lymphopenie und Thrombozytopenie, ebenso erhöhte D‑Dimere [ 43 , 56 ]. Bei Vorliegen einer kardialen Beteiligung können das nt-proBNP sowie Troponin erhöht sein.…”

Anti-inflammatory Treatment of Kawasaki Disease: Comparison of Current Guidelines and Perspectives

“…KD and so-JIA share many common clinical and laboratory features. So-JIA can be initially diagnosed as KD and vice versa (123)(124)(125). CAL can be also found in soJIA.…”