Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9–12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL, p = 0.028; platelet count 166 vs. 216 cells × 10 3 /μL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% ( p < 0.001, 95% CI 0.217–0.550), lethargy increased the risk of overlap with KD by 2.6-fold ( p = 0.011, 95% CI 1.244–5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% ( p < 0.001, 95% CI 0.298–0.559). Conclusion : Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD. What is Known: • In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease. • Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C. What is New: • Half of the patients had clinical features that overlapped with Kawasaki disease. • In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal. • Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C pa...

Objective The aim of this study was to determine the role of thiol/disulfide homeostasis (TDH) parameters which are new oxidative stress markers for the diagnosis of acute appendicitis (AA) in children with abdominal pain complaints. Methods A total of 40 patients with AA and 45 patients with abdominal pain were included in this study. Two groups were compared in terms of age, gender, white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), appendix diameter, and TDH parameters (native and total thiol levels, native thiol/total thiol ratio [antioxidant parameters] and disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio [oxidant parameters]). Results Compared with the abdominal pain group, it was found that disulfide level, disulfide/native thiol, and disulfide/total thiol ratios (p < 0.001 for all) in patients with AA were significantly higher and their native thiol level (p = 0.02) and native thiol/total thiol ratio (p < 0.001) were significantly lower. There was no significant difference between the two groups in terms of total thiol level. There was no significant difference between the perforated and nonperforated groups in patients with AA in terms of TDH parameters. In addition, the CRP level was higher in the perforated group than the nonperforated group. Conclusion To our knowledge, the present study is a first in the literature in which TDH parameters were used in children with AA compared with the abdominal pain group. We thought that these parameters may be useful as new biomarkers supporting AA diagnosis in children.

Aim: The aim of this study was to determine the usefulness of systemic immune-inflammation index (SII) in the diagnosis of acute appendicitis (AA) in children Material and Method: This study was done retrospectively, and two groups were formed as AA and control group. AA group was divided into two subgroups as nonperforated appendicitis and perforated appendicitis. The groups were compared for age, sex, WBC, neutrophil, lymphocyte and platelet count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein (CRP). Results: The study included a total of 162 children. There were 81 children in the AA group and 81 in the control group. Of 81 patients included in the AA group, 31 were girls (38.3%) and 50 were boys (61.7%), and the median age of the patients was 11 (5) years. When the AA group and the control group were compared in terms of laboratory values. It was found that WBC count, neutrophil count, platelet count, NLR, PLR and SII in the AA group were significantly higher and lymphocyte count was significantly lower (p