Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

Cem, Ela; Böncüoğlu, Elif; Kıymet, Elif; Şahinkaya, Şahika; Çelebi, Miray Yılmaz; Gülderen, Mustafa; Kaçar, Pelin; Kara, Aybüke Akaslan; Aydın, Ayşenur; Murat, Mehmet; Yılmazer, Murat Muhtar; Bayram, Nuri; Devrim, İlker

doi:10.1007/s00246-022-02961-6

Cited by 7 publications

(9 citation statements)

References 37 publications

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“…Additionally, myocarditis is more common and severe in PIMS-TS. Hypoalbuminemia, lymphopenia, and renal insufficiency are also more apparent [6,7]. This clinical case sheds light on hypoalbuminemia as an important feature in PIMS-TS, associated in most cases with the severe evolution of this syndrome [7], which fits with the results of the literature [6,7].…”

Section: Discussionsupporting

confidence: 83%

Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS) and Serous Effusions in a Child With Severe Hypoalbuminemia: A Case Report

Haddar¹,

Elouali²,

Belga³

et al. 2023

Cureus

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In April 2020, Pediatric Inflammatory Multisystem Syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 (PIMS-TS) was described for the first time in children. Since then, many countries have registered hundreds of cases with clinical similarities to Kawasaki disease. We report the case of a five-year-old boy diagnosed with PIMS-TS who presented myocarditis with serous effusions (pleurisy, ascites, pericarditis) due to severe hypoalbuminemia. This case sheds light on the importance of hypoalbuminemia in evaluating the severity of PIMS-TS and preventing its complications. The patient was successfully treated with intravenous immunoglobulins and oral prednisone.

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Section: Discussionsupporting

confidence: 83%

Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS) and Serous Effusions in a Child With Severe Hypoalbuminemia: A Case Report

Haddar¹,

Elouali²,

Belga³

et al. 2023

Cureus

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“…This finding is consistent with previous studies. [13][14][15][16] As in the literature, the male gender was dominant in both disease groups, but the difference between the groups was not statistically significant. 13,15,16 It has been reported that mucocutaneous symptoms (conjunctivitis, erythematous/chapped lip), changes in the limbs (desquamation), and cervical LAP were more common in KD patients than in MIS-C patients.…”

Section: Discussionmentioning

confidence: 47%

Comparison of Characteristics and Outcomes of Multisystem Inflammatory Syndrome and Prepandemic Kawasaki's Disease

Ünlü,

Özel,

Büke

et al. 2024

J Pediatr Infect Dis

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Objective In this study, our objective is to compare the demographic, clinical, laboratory, and echocardiographic findings of patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki's disease (KD) diagnosed in the prepandemic period. Methods We retrospectively collected data from all pediatric patients who met the Centers for Disease Control and Prevention's MIS-C case definition and who met the American Heart Association's definition of complete KD before the coronavirus disease 2019 pandemic. Results A total of 37 patients diagnosed with MIS-C and 40 patients diagnosed with complete KD were included. Gastrointestinal findings were significantly higher in the MIS-C group than in the KD group (vomiting [p = 0.009], diarrhea [p = 0.009]). The incidence of thrombocytopenia (48.6%) was significantly higher in the MIS-C group. Regarding inflammatory markers, procalcitonin and ferritin were significantly higher in the MIS-C group (p = 0.032 and p = 0.006) and the erythrocyte sedimentation rate was higher in the KD group (p < 0.001). Pericardial effusion and mitral valve regurgitation were significantly more frequent in the MIS-C group (p = 0.024 and p = 0.001). Conclusion Although they have similar findings, our current study findings show that MIS-C and KD differ from each other with different clinical and laboratory features. We think that these differences will help clinicians in diagnosis and patient management.

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“…54 In comparison to multisystem inflammatory syndrome, patients with Kawasaki disease are less likely to have lymphopenia but are more likely to have leukocytosis and neutrophilia. [55][56][57][58] In Kawasaki disease, absolute lymphocyte count remains stable in the acute, subacute, and convalescent phase of the disease, and it is rather the lymphocyte percentage that increases after ntravenous immune globulin treatment. 59 Instead of a specific value of either lymphocytes or neutrophils, studies have looked at the neutrophil-to-lymphocyte ratio in Kawasaki disease.…”

Section: Discussionmentioning

confidence: 99%

The use of neutrophil–lymphocyte ratio for the prediction of refractory disease and coronary artery lesions in patients with Kawasaki disease

et al. 2023

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Background: Kawasaki disease is a vasculitis that can lead to cardiac complications, including coronary artery disease and cardiogenic shock. Various scoring systems have been developed to determine those that will be refractory to routine intravenous immunoglobulin therapy or develop coronary artery disease. The objective of this study was to determine if the neutrophil–lymphocyte ratio could predict refractory disease and coronary artery lesions in patients with Kawasaki disease. Methods: A systematic review of the literature was performed to identify manuscripts describing comparisons of neutrophil–lymphocyte ratio between those who had refractory disease and those who did not, and between those who developed coronary artery lesions and those who did not. Mean difference was compared between groups. Areas under the curve were utilised to determine the pooled area under the curve. Results: 12 studies with 5593 patients were included in the final analyses of neutrophil–lymphocyte ratio for the prediction of refractory disease. Neutrophil–lymphocyte ratio before therapy was higher in refractory disease with a mean difference of 2.55 (p < 0.01) and pooled area under the curve of 0.724. Neutrophil–lymphocyte ratio after therapy was higher in refractory disease with a mean difference of 1.42 (p < 0.01) and pooled area under the curve for of 0.803. Five studies with 1690 patients were included in the final analyses of neutrophil–lymphocyte ratio for the prediction of coronary artery lesions. Neutrophil–lymphocyte ratio before therapy was higher in coronary artery lesions with a mean difference of 0.65 (p < 0.01). Conclusion: The use of neutrophil–lymphocyte ratio may help physicians in the identification of patients at risk of refractory disease and coronary artery lesions in patients with Kawasaki disease.

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Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

Cited by 7 publications

References 37 publications

Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS) and Serous Effusions in a Child With Severe Hypoalbuminemia: A Case Report

Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS) and Serous Effusions in a Child With Severe Hypoalbuminemia: A Case Report

Comparison of Characteristics and Outcomes of Multisystem Inflammatory Syndrome and Prepandemic Kawasaki's Disease

The use of neutrophil–lymphocyte ratio for the prediction of refractory disease and coronary artery lesions in patients with Kawasaki disease

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