tetano
Editor, Senior Moderator
Rheumatol Int
. 2020 Nov 21.
doi: 10.1007/s00296-020-04749-4. Online ahead of print.
Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management
Jayakanthan Kabeerdoss[SUP] 1 [/SUP], Rakesh Kumar Pilania[SUP] 2 [/SUP], Reena Karkhele[SUP] 3 [/SUP], T Sathish Kumar[SUP] 4 [/SUP], Debashish Danda[SUP] 5 [/SUP], Surjit Singh[SUP] 6 [/SUP]
Affiliations
Abstract
Multisystem inflammatory syndrome (MIS-C) is a pediatric hyperinflammation disorder caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It has now been reported from several countries the world over. Some of the clinical manifestations of MIS-C mimic Kawasaki disease (KD) shock syndrome. MIS-C develops 4-6 weeks following SARS-CoV-2 infection, and is presumably initiated by adaptive immune response. Though it has multisystem involvement, it is the cardiovascular manifestations that are most prominent. High titres of anti-SARS-CoV-2 antibodies are seen in these patients. As this is a new disease entity, its immunopathogenesis is not fully elucidated. Whether it has some overlap with KD is still unclear. Current treatment guidelines recommend use of intravenous immunoglobulin and high-dose corticosteroids as first-line treatment. Mortality rates of MIS-C are lower compared to adult forms of severe COVID-19 disease.
Keywords: Coronavirus disease 2019; Hyperinflammation; Kawasaki disease (KD); Kawasaki-like disease; Multisystem inflammatory syndrome (MIS-C).
. 2020 Nov 21.
doi: 10.1007/s00296-020-04749-4. Online ahead of print.
Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management
Jayakanthan Kabeerdoss[SUP] 1 [/SUP], Rakesh Kumar Pilania[SUP] 2 [/SUP], Reena Karkhele[SUP] 3 [/SUP], T Sathish Kumar[SUP] 4 [/SUP], Debashish Danda[SUP] 5 [/SUP], Surjit Singh[SUP] 6 [/SUP]
Affiliations
- PMID: 33219837
- DOI: 10.1007/s00296-020-04749-4
Abstract
Multisystem inflammatory syndrome (MIS-C) is a pediatric hyperinflammation disorder caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It has now been reported from several countries the world over. Some of the clinical manifestations of MIS-C mimic Kawasaki disease (KD) shock syndrome. MIS-C develops 4-6 weeks following SARS-CoV-2 infection, and is presumably initiated by adaptive immune response. Though it has multisystem involvement, it is the cardiovascular manifestations that are most prominent. High titres of anti-SARS-CoV-2 antibodies are seen in these patients. As this is a new disease entity, its immunopathogenesis is not fully elucidated. Whether it has some overlap with KD is still unclear. Current treatment guidelines recommend use of intravenous immunoglobulin and high-dose corticosteroids as first-line treatment. Mortality rates of MIS-C are lower compared to adult forms of severe COVID-19 disease.
Keywords: Coronavirus disease 2019; Hyperinflammation; Kawasaki disease (KD); Kawasaki-like disease; Multisystem inflammatory syndrome (MIS-C).