Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study

Kostik, Mikhail M.; Bregel, L.V.; Avrusin, Ilia S.; Дондурей, Е. А.; Matyunova, A.E.; Efremova, Olesya S.; Исупова, Е. А.; Kornishina, Tatiana; Masalova, Vera; Snegireva, Ludmila; Шпрах, В. В.; Kozlov, Yuri A.; Kalashnikova, Olga V.; Chasnyk, Vyacheslav

doi:10.3389/fped.2021.787353

Cited by 35 publications

(51 citation statements)

References 37 publications

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“…Lymphopenia and thrombocytopenia have been reported in the literature to accompany MIS-C cases, as seen in our study, whereas leukocytosis was observed in Kawasaki patients. In addition, sedimentation, CRP, ferritin, and D-dimer levels were also higher as acutephase reactants in patients with MIS-C in previous studies [4,19,28]. However, no significant difference was found between the two groups in our study from the standpoint of acute-phase reactants.…”

Section: Discussioncontrasting

confidence: 65%

“…According to this study, the duration of fever before diagnosis was shorter in MIS-C, which is consistent with other studies. Furthermore, in other studies, the fever resolved in a shorter period [19]. One of the most important factors affecting this result is thought to be the difference in diagnostic criteria.…”

Section: Discussionmentioning

confidence: 85%

“…As a result, according to reports, including our own, gastrointestinal symptoms are more common in MIS-C, such as the study of Abraham et al [23], which had more than 80% of MIS-C cases present with gastrointestinal symptoms. In reality, cases of appendectomy performed due to misdiagnosis have been reported in the literature [19,24].…”

Section: Discussionmentioning

confidence: 99%

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Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

et al. 2022

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Multisystem Inflammatory Syndrome in Children associated with COVID-19 infection attracted attention because some features overlapped with Kawasaki disease. And due to these overlapping features with Kawasaki disease, it has become difficult to diagnose both disorders. Therefore, this study focused on the differences between the patients diagnosed with MIS-C after COVID-19 and Kawasaki patients analyzed, particularly during the pre-pandemic period. In this way, it is aimed to reduce the dilemmas experienced in Diagnosis. In this descriptive study, 98 patients diagnosed with MIS-C throughout the pandemic were compared to 37 patients diagnosed with Kawasaki Disease during the pre-pandemic period. The patients in the MIS-C group were older children and clinically suffered from more headaches, vomiting, diarrhea, abdominal pain, and chest pain than Kawasaki patients. Signs of shock such as hypotension and tachycardia were more remarkable. Also, myocarditis and mitral regurgitation were detected at a higher rate in the MIS-C group. Besides, in the laboratory, lymphopenia, hypoalbuminemia, and creatinine elevation were more apparent. In conclusion, our present study findings support that although the MIS-C and Kawasaki share common features, they present with different clinical and laboratory features. And these differences are thought to be supportive in treatment and patient management. KeywordsMultisystem inflammatory syndrome in children • MIS-C • Kawasaki disease • Children * Ela Cem

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 85%

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Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

et al. 2022

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“…A strength of our work is the universal availability of the required features in the majority of healthcare settings and the validation using external cohorts. The only published model addressing a machine learning approach to MIS-C diagnosis includes features that may not be available in many clinical settings such as ferritin and D-dimer 15 . In addition, the model was not tested against febrile pediatric control patients and was not externally validated.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Validation of a Machine Learning Algorithm for Diagnosing Pediatric Patients with Multisystem Inflammatory Syndrome and Kawasaki Disease

Lam

Roberts

Shimizu

et al. 2022

Preprint

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Multisystem inflammatory syndrome in children (MIS-C) is a novel disease identified during the COVID-19 pandemic characterized by systemic inflammation following SARS-CoV-2 infection. Delays in diagnosing MIS-C may lead to more severe disease with cardiac dysfunction or death. Most pediatric patients recover fully with anti-inflammatory treatments, but early detection of MIS-C remains a challenge given its clinical similarities to Kawasaki disease (KD) and other acute childhood illnesses. We present KIDMATCH (KawasakI Disease vs Multisystem InflAmmaTory syndrome in CHildren), a deep learning algorithm for screening patients for MIS-C, KD, or other febrile illness. KIDMATCH incorporates a conformal prediction framework to tag patients with erroneous data or distribution shifts, enhancing the model generalizability and confidence by flagging unfamiliar cases as indeterminate instead of making spurious predictions. Using routinely collected clinical and laboratory data, KIDMATCH achieved a high area under the curve [0.95-0.98]. Additional external validation of this model on MIS-C patients from 16 hospitals across the United States achieved a positive detection rate of over 90%. Our algorithm has the potential to aid frontline clinicians with distinguishing between MIS-C, KD, and similar febrile illnesses in a timely manner to allow prompt treatment and prevent severe complications.

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“…Children with MIS-C are often older than 5 years of age ( 18 ). Laboratory tests might show thrombocytopenia, the elevation of CRP, ferritin, troponin, and D-dimer in patients with MIS-C ( 25 , 26 ). Our case showed symptoms of fever, skin rash, conjunctival injection, and periungual peeling of skin in the fingers and toes, which could be found in KD and MIS-C.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Lower Limb Muscle Weakness in a Child With Kawasaki Disease

Huang

Peng²,

Li³

et al. 2022

Front. Pediatr.

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Kawasaki disease (KD) is a systemic vasculitis that may impact multiple organ systems in children. Myositis is an unusual presentation of KD that presents with muscle weakness. To date, a few pediatric patients with KD and myositis have been reported. Diffuse muscle weakness involving the 4 limbs was the most common presentation in these children. However, isolated lower limb involvement was rarely reported before. Here, we report lower limb muscle weakness in an 18-month-old child with KD. He presented with fever, rash, conjunctival injection, peeling over fingers and toes, and progressive muscle weakness of the lower limbs. Muscle enzymes were normal, but electromyography indicated myositis. The symptom of fever was relieved quickly by intravenous immunoglobulin and aspirin, which were ineffective for myositis. However, lower limb muscle weakness fully recovered 5 days after prednisolone treatment. This rare case might add value to the growing literature exploring the association of KD with myositis.

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Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study

Cited by 35 publications

References 37 publications

Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

Which Findings Make multisystem Inflammatory Syndrome in Children Different from the Pre-Pandemic Kawasaki Disease?

Multicenter Validation of a Machine Learning Algorithm for Diagnosing Pediatric Patients with Multisystem Inflammatory Syndrome and Kawasaki Disease

Case Report: Lower Limb Muscle Weakness in a Child With Kawasaki Disease

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