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Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison

Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reporte...

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Autores principales: Sharma, Chetan, Ganigara, Madhusudan, Galeotti, Caroline, Burns, Joseph, Berganza, Fernando M., Hayes, Denise A., Singh-Grewal, Davinder, Bharath, Suman, Sajjan, Sujata, Bayry, Jagadeesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554518/
https://www.ncbi.nlm.nih.gov/pubmed/34716418
http://dx.doi.org/10.1038/s41584-021-00709-9
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author Sharma, Chetan
Ganigara, Madhusudan
Galeotti, Caroline
Burns, Joseph
Berganza, Fernando M.
Hayes, Denise A.
Singh-Grewal, Davinder
Bharath, Suman
Sajjan, Sujata
Bayry, Jagadeesh
author_facet Sharma, Chetan
Ganigara, Madhusudan
Galeotti, Caroline
Burns, Joseph
Berganza, Fernando M.
Hayes, Denise A.
Singh-Grewal, Davinder
Bharath, Suman
Sajjan, Sujata
Bayry, Jagadeesh
author_sort Sharma, Chetan
collection PubMed
description Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4(+) T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm.
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spelling pubmed-85545182021-10-29 Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison Sharma, Chetan Ganigara, Madhusudan Galeotti, Caroline Burns, Joseph Berganza, Fernando M. Hayes, Denise A. Singh-Grewal, Davinder Bharath, Suman Sajjan, Sujata Bayry, Jagadeesh Nat Rev Rheumatol Review Article Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4(+) T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm. Nature Publishing Group UK 2021-10-29 2021 /pmc/articles/PMC8554518/ /pubmed/34716418 http://dx.doi.org/10.1038/s41584-021-00709-9 Text en © Springer Nature Limited 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Review Article
Sharma, Chetan
Ganigara, Madhusudan
Galeotti, Caroline
Burns, Joseph
Berganza, Fernando M.
Hayes, Denise A.
Singh-Grewal, Davinder
Bharath, Suman
Sajjan, Sujata
Bayry, Jagadeesh
Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title_full Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title_fullStr Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title_full_unstemmed Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title_short Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison
title_sort multisystem inflammatory syndrome in children and kawasaki disease: a critical comparison
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554518/
https://www.ncbi.nlm.nih.gov/pubmed/34716418
http://dx.doi.org/10.1038/s41584-021-00709-9
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