Immunophenotyping of peripheral blood cells allows to discriminate MIS-C and Kawasaki disease

Abstract

Background The pathogenesis of the novel described multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) is still debated as it is not clear if they are the same or different nosological entities. However, for both the diseases a rapid and unequivocal diagnosis is mandatory to start the therapy before the onset of severe complications. In this study, we aimed to evaluate the white cell populations in MIS-C and KD as potential markers to discriminate between the two diseases. Methods We studied white cell populations by flow cytometry in 46 MIS-C and 28 KD patients in comparison to 70 age-matched healthy children. Results MIS-C patients had a significant lymphopenia that involved both B and T populations while KD patients showed a significant neutrophilia and thrombocythemia. Granulocyte/lymphocyte ratio helped to diagnose both MIS-C and KD with a high diagnostic sensitivity, while a multivariate analysis of granulocyte and T lymphocyte number contributed to discriminate between the two diseases. Conclusions The relevant lymphopenia observed in MIS-C patients suggests that the disease would be a post-infectious sequel of COVID-19 immunologically amplified by a massive cytokine release, while the significant neutrophilia and thrombocythemia observed in KD confirmed that the disorder has the genesis of a systemic vasculitis. The analysis of a panel of circulating cells may help to early diagnose and to discriminate between the two diseases.

The Immune Response to SARS-CoV-2 Vaccine in a Cohort of Family Pediatricians from Southern Italy

“…We speculate that IFN-γ has a main role in viral clearance. In all these 6 subjects, the flow-cytometry panel [41] resulted normal; furthermore, we analyzed a panel of 364 genes related to immunodeficiency [42], excluding any genetic alteration, and we did not find any correlation with age. At the state of the art, we are unable to define the cause of the lack of T-cell response after the vaccine.…”

Progress in the Diagnosis and Treatment of Kawasaki Disease and Other Multi-system Inflammatory Syndromes by Artificial Intelligence

“…The difference is that the associated lymphocytopenia observed in patients with MIS-C has been compared to the significant neutrophilism and thrombocytosis observed in KD [4]. Other studies have found that the number of related lymphocytes observed in patients with MIS-C is decreased, while the number of neutrophils and platelets observed in KD is significantly increased [5]. In patients with MIS-C tested by deep immunoassay, a significant reduction of lymphocytes was found in a short period, while T cell involvement was more pronounced.…”