tetano
Editor, Senior Moderator
Nat Rev Rheumatol
. 2021 Oct 29.
doi: 10.1038/s41584-021-00709-9. Online ahead of print.
Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
Chetan Sharma[SUP] #[/SUP][SUP] 1 [/SUP], Madhusudan Ganigara[SUP] #[/SUP][SUP] 2 [/SUP], Caroline Galeotti[SUP] 3 [/SUP], Joseph Burns[SUP] 4 [/SUP], Fernando M Berganza[SUP] 5 [/SUP], Denise A Hayes[SUP] 6 [/SUP], Davinder Singh-Grewal[SUP] 7 [/SUP], Suman Bharath[SUP] 8 [/SUP], Sujata Sajjan[SUP] 9 [/SUP], Jagadeesh Bayry[SUP] 10 11 [/SUP]
Affiliations
Abstract
Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4[SUP]+[/SUP] T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm.
. 2021 Oct 29.
doi: 10.1038/s41584-021-00709-9. Online ahead of print.
Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
Chetan Sharma[SUP] #[/SUP][SUP] 1 [/SUP], Madhusudan Ganigara[SUP] #[/SUP][SUP] 2 [/SUP], Caroline Galeotti[SUP] 3 [/SUP], Joseph Burns[SUP] 4 [/SUP], Fernando M Berganza[SUP] 5 [/SUP], Denise A Hayes[SUP] 6 [/SUP], Davinder Singh-Grewal[SUP] 7 [/SUP], Suman Bharath[SUP] 8 [/SUP], Sujata Sajjan[SUP] 9 [/SUP], Jagadeesh Bayry[SUP] 10 11 [/SUP]
Affiliations
- PMID: 34716418
- DOI: 10.1038/s41584-021-00709-9
Abstract
Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4[SUP]+[/SUP] T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm.