Multisystemic Inflammatory Syndrome in Children and Kawasaki Disease: Parallels in Pathogenesis and Treatment

Curr Allergy Asthma Rep. 2023 Jun;23(6):341-350. doi: 10.1007/s11882-023-01083-0. Epub 2023 May 12.

Abstract

Purpose of review: Since it first appeared, multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) has been compared to Kawasaki disease (KD). Although there were early parallels between MIS-C and KD, key differences emerged over time. Here, we aim to compare the pathogenesis, clinical presentation, treatment, and outcomes of MIS-C and KD.

Recent findings: In this article, we review and compare MIS-C and KD, highlighting differentiating features. We discuss the epidemiological and immunological factors along with clinical and laboratory features which discern MIS-C from KD. We also compare treatment and our understanding of long-term outcomes. Though parallels exist between MIS-C and KD, distinguishing the two is important for clinical management of patients, counseling about natural history, and determining long-term monitoring. While both MIS-C and KD are characterized by profound inflammation and inflammatory vasculopathy, further study is needed to determine whether they are distinct immunopathogenic disorders.

Keywords: Coronary artery aneurysm; Intravenous immunoglobulin; Kawasaki disease; Multisystem inflammatory syndrome in children.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19*
  • Child
  • Humans
  • Inflammation
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Mucocutaneous Lymph Node Syndrome* / therapy
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / therapy

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related