PMID- 34013488 OWN - NLM STAT- MEDLINE DCOM- 20210819 LR - 20210819 IS - 1867-0687 (Electronic) IS - 1708-8569 (Print) VI - 17 IP - 4 DP - 2021 Aug TI - Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. PG - 335-340 LID - 10.1007/s12519-021-00435-y [doi] AB - BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spreading rapidly around the world, while "multisystem inflammatory syndrome in children" (MIS-C) is a new type of syndrome that has now been reported in many countries. Similar and different characteristics between KD and MIS-C have been reported in a variety of literature. We aimed to focus on reviewing clinical presentations, diagnosis, and treatment of KD and MIS-C. METHODS: We searched articles in the electronic databases, including the Cochrane Library database, EMBASE, and MEDLINE with the keywords "multiple inflammatory syndrome" and/or "COVID-19" and/or "Kawasaki disease" and "children". RESULTS: Main presentations of MIS-C and KD include fever, rashes, mucous membrane involvement, conjunctivitis, hands and feet erythema/edema, and cervical lymphadenopathy. However, compared with the highest incidence of KD among some Asian countries, MIS-C is common among Black and Hispanic children. MIS-C is common in older children and teenagers, whereas classic KD is common in children under five years of age. Gastrointestinal symptoms, shock, and coagulopathy are common in MIS-C patients but are not common in classic KD. Cardiac manifestations are more common than KD, including myocarditis with cardiac dysfunction and coronary artery dilation or aneurysms. Severe cases in MIS-C present with vasodilated or cardiogenic shock that requires fluid resuscitation, muscular support, and even mechanical ventilation and extracorporeal membrane oxygenation (ECMO), whereas KD rarely presents with these manifestations and requires these treatments. Increased serum ferritin, leukopenia, lymphopenia and thrombocytopenia are common in MIS-C. However, thrombocytosis is a characteristic feature of KD. Intravenous immunoglobulin (IVIG) and moderate-high dose aspirin are still a standard recommended treatment for KD. In addition to the above-mentioned medications, steroids and biological drugs are frequently used in patients with MIS-C. Most of the children with KD have a good prognosis; however, the long-term clinical outcomes of MIS-C are not clear. CONCLUSIONS: The overall presentation and treatment of MIS-C appear to overlap with KD. However, there are still great differences between the syndromes, and it is controversial to say whether MIS-C is a new entity or is a "severe type" of KD. CI - (c) 2021. Children's Hospital, Zhejiang University School of Medicine. FAU - Zhang, Qing-You AU - Zhang QY AD - Department of Pediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing, 100034, China. FAU - Xu, Bo-Wen AU - Xu BW AD - Department of Pediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing, 100034, China. FAU - Du, Jun-Bao AU - Du JB AD - Department of Pediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing, 100034, China. junbaodu1@126.com. LA - eng GR - 7171010/Bejing Natural Science Foundation/ PT - Journal Article PT - Review DEP - 20210520 PL - Switzerland TA - World J Pediatr JT - World journal of pediatrics : WJP JID - 101278599 RN - pediatric multisystem inflammatory disease, COVID-19 related SB - IM MH - COVID-19/*diagnosis/*therapy MH - Child MH - Diagnosis, Differential MH - Humans MH - Mucocutaneous Lymph Node Syndrome/*diagnosis/*therapy MH - SARS-CoV-2 MH - Systemic Inflammatory Response Syndrome/*diagnosis/*therapy PMC - PMC8134825 OTO - NOTNLM OT - Children OT - Kawasaki disease OT - Multisystem inflammatory syndrome COIS- Professor Junbao Du serves as an associate editor for this journal. The paper was handled by the other Editor and has undergone rigrous peer review process. None of the authors participated in the journal's review of, or decisions related to this manuscript. All authors declared no finanacial or non-financial conflict of interests related to this paper. EDAT- 2021/05/21 06:00 MHDA- 2021/08/20 06:00 PMCR- 2021/05/20 CRDT- 2021/05/20 06:56 PHST- 2021/01/07 00:00 [received] PHST- 2021/04/29 00:00 [accepted] PHST- 2021/05/21 06:00 [pubmed] PHST- 2021/08/20 06:00 [medline] PHST- 2021/05/20 06:56 [entrez] PHST- 2021/05/20 00:00 [pmc-release] AID - 10.1007/s12519-021-00435-y [pii] AID - 435 [pii] AID - 10.1007/s12519-021-00435-y [doi] PST - ppublish SO - World J Pediatr. 2021 Aug;17(4):335-340. doi: 10.1007/s12519-021-00435-y. Epub 2021 May 20.