Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: Common Inflammatory Pathways of Two Distinct Diseases

Rheum Dis Clin North Am. 2023 Aug;49(3):647-659. doi: 10.1016/j.rdc.2023.03.002. Epub 2023 Mar 17.

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a delayed postinflammatory disorder associated with the previous infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, MIS-C was described as highly similar to Kawasaki disease (KD), a pediatric febrile systemic vasculitis that can lead to the development of coronary artery aneurysms (CAAs). While KD and MIS-C are both inflammatory disorders, the 2 entities differ in their epidemiological, clinical, immunological, and pathological features. MIS-C clinical and laboratory characteristics are more closely related to toxic shock syndrome (TSS) than KD, which informs the understanding of pathogenesis and potential therapeutic approaches.

Keywords: Kawasaki disease; Multisystem inflammatory syndrome in children; SARS-CoV-2; Superantigen; Superantigen-like motif; Toxic shock syndrome.

Publication types

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

MeSH terms

  • COVID-19* / complications
  • Child
  • Humans
  • Mucocutaneous Lymph Node Syndrome* / complications
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / etiology

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related