Multisystem inflammatory syndrome associated with SARS‐CoV‐2 in a Japanese girl

Baba, Tomoaki; Maruyama, Tomoko; Katsuragi, Shinichi; Maeda, Kento; Kogaki, Shigetoyo

doi:10.1111/ped.14704

Cited by 9 publications

(9 citation statements)

References 4 publications

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“…She also fulfilled the US Centers for Disease Control and Prevention and World Health Organization criteria for COVID‐19 1 . Gastrointestinal symptoms, which had been seen in five previously reported MIS‐C patients from Japan, 4–8 were not observed in this case. However, erythema around the eyelids and periorbital edema, which are characteristic findings in patients with MIS‐C, 9 were observed.…”

Section: Figuresupporting

confidence: 56%

Coronavirus disease 2019‐associated multisystem inflammatory syndrome and Kawasaki disease

Uejima

Suganuma

Matsunaga

et al. 2022

Pediatrics International

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Section: Figuresupporting

confidence: 56%

Coronavirus disease 2019‐associated multisystem inflammatory syndrome and Kawasaki disease

Uejima

Suganuma

Matsunaga

et al. 2022

Pediatrics International

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“…Only four case reports described Japanese MIS-C patients [ [20] , [21] , [22] , [23] ] and suggested similarities and differences of clinical and laboratory phenotypes compared to patients in other regions or races. Although Japanese MIS-C patients had quite similar clinical symptoms, the frequencies of shock and ICU admission may be lower than in the other cohorts ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Infliximab treatment for refractory COVID-19-associated multisystem inflammatory syndrome in a Japanese child

Yamaguchi

Takasawa

Irabu

et al. 2022

Journal of Infection and Chemotherapy

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Patients with multisystem inflammatory syndrome in children (MIS-C) can develop clinical features resembling Kawasaki disease (KD). A full picture of MIS-C in East Asia which has higher incidence of KD than other regions remains unclear. We report on a 15-year-old Japanese boy with refractory MIS-C who was successfully treated with infliximab. A Japanese boy who was diagnosed with coronavirus disease 2019 (COVID-19) before a month developed MIS-C with fulfilling six principal symptoms of KD. Laboratory data showed extreme hyperferritinemia (11,404 ng/mL), besides lymphopenia and thrombocytopenia. The patient was refractory to initial therapy with intravenous immunoglobulin (IVIG; 2 g/kg), aspirin, and prednisolone. He was therefore administered a second IVIG (2 g/kg) and infliximab (5 mg/kg) on days 7 and 8 from the onset of fever, respectively, which resulted in an improvement of clinical symptoms. Only four Japanese cases with MIS-C were reported and all of them were responsive to IVIG. The hyperferritinemia in this case was distinctive from previously reported MIS-C cases in Japan and other cohorts and may be associated with refractoriness to IVIG therapy. Marked elevation of circulating ferritin levels is known to be induced by tumor necrosis factor-α, which plays a key role in the pathogenesis of both KD and MIS-C. Thus, for MIS-C patients with hyperferritinemia, early intervention with adjunctive infliximab may induce a more rapid resolution of inflammation and improve outcome. Because MIS-C may be heterogeneous with respect to immunopathology, genetic background, clinical phenotypes and response to therapies, optimized treatment strategies according to immunopathogenesis are required.

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“…In Japan, a few cases of MIS-C or PIMS were reported after December 2020 [26][27][28][29]. We reviewed those reports according to the items in Table 1, and added Table 2, and their summary is added on Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…However, only a few patients have a possibility to develop signs of MIS-C or PIMS-TS after several weeks in Japan. Until October 2021, a few unpublished cases of MIS-C or PIMS were informed in addition to four published cases [26][27][28][29]. However, MIS-C or PIMS is still very rare, counting approximately 10 in Japan.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Kawasaki Disease Patients during the COVID-19 Pandemic in Japan: A Single-Center, Observational Study

Shimizu

Ayusawa

et al. 2021

Children

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Background: Under the Coronavirus disease 2019 (COVID-19) pandemic, manifestations in children with Kawasaki disease (KD) are different between the Western and the Eastern countries. Particularly, there has not been a report comparing a series of KD in Japan, where KD was originally discovered and has a large number of registered cases. Methods: We compared patients with KD under the period of the COVID-19 pandemic in Japan with the report from Italy during its reported period by a retrospective, cohort, observational study in a Japanese single center. Results: Thirty-two patients with typical KD were treated during the study period, while the Italian study reported 10 patients with the signs of KD. Concerning the proof of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, none (0%) of our KD cases showed a positive result and one and no patients developed the macrophage activation syndrome (MAS) and Kawasaki disease shock syndrome (KDSS), respectively; however, eight (80%) patients in the Italian series were confirmed with SARS-CoV-2 infection. MAS and KDSS developed in six and five patients, respectively. Conclusions: Cases reported as COVID-19 pandemic-related KD in Italy showed significantly different clinical characteristics from the typical KD symptoms known in Japan. Although they show KD-like manifestations, we cannot conclude that SARS-CoV-2 has the same etiology of our ‘classic‘ KD at the present stage.

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Multisystem inflammatory syndrome associated with SARS‐CoV‐2 in a Japanese girl

Cited by 9 publications

References 4 publications

Coronavirus disease 2019‐associated multisystem inflammatory syndrome and Kawasaki disease

Coronavirus disease 2019‐associated multisystem inflammatory syndrome and Kawasaki disease

Infliximab treatment for refractory COVID-19-associated multisystem inflammatory syndrome in a Japanese child

Characteristics of Kawasaki Disease Patients during the COVID-19 Pandemic in Japan: A Single-Center, Observational Study

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