Abstract
To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory characteristics of MIS-C, KD and an intermediate group, which met the case definitions of both conditions. MIS-C patients were older, were more likely to be hypotensive, to have significant gastrointestinal symptoms, lymphopenia and thrombocytopenia and to have non-coronary abnormal findings in their echocardiogram. Lymphopenia was an independent predictor of MIS-C. Most of our MIS-C patients responded promptly to corticosteroid therapy. KD incidence in both centers was similar in 2019 and 2020. Although there is clinical overlap between KD and MIS-C, these are separate entities. Lymphopenia clearly differentiates between these entities. MIS-C patients may benefit from corticosteroids as first-line therapy.
Highlights
To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD)
Since Kawasaki disease (KD) shares some of the clinical and laboratory features with this new entity, and both rely for their diagnosis on a set of non-specific criteria, it was suggested that both KD and MIS-C are part of the spectrum of SARS-CoV-2-related inflammatory illness[2,8]
One patient without cardiovascular symptoms had severe headache with magnetic resonance imaging (MRI) showing a cytotoxic lesion in the corpus callosum, which was interpreted as a non-specific finding[12]
Summary
To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). Since Kawasaki disease (KD) shares some of the clinical and laboratory features with this new entity (fever, rash, conjunctival injection, elevated inflammatory markers), and both rely for their diagnosis on a set of non-specific criteria, it was suggested that both KD and MIS-C are part of the spectrum of SARS-CoV-2-related inflammatory illness[2,8]. This question has prognostic as well as therapeutic implications. Our aim is to report our experience during the COVID-19 pandemic with pediatric patients presenting with fever and inflammation (without known etiology) and characterize features that may help differentiating KD from MIS-C
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