Zane Davidsone (Latvia)
Children's Clinical University Hospital Department of RheumatologyAuthor Of 1 Presentation
COMPARISON OF CLINICAL FEATURES OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN, KAWASAKI DISEASE AND TOXIC SHOCK SYNDROME
Abstract
Backgrounds:
The COVID-19 pandemic has brought numerous challenges. One of them is multisystem inflammatory syndrome in children (MIS-C), developing two to six weeks after acute SARS-CoV-2 infection. This study aimed to describe the clinical characteristics of patients who met the criteria for MIS-C, and compare them with the features of Kawasaki disease (KD) and toxic shock syndrome (TSS).
Methods
This retrospective study was conducted at the Children's Clinical University Hospital in Riga, Latvia, and involved children <18 years old who were hospitalized during the period from 2012 to 2021 with MIS-C, KD or TSS. Clinical data was collected from medical records and analysed using descriptive parametric and non-parametric statistics. A statistically significant difference between groups was assumed where p value <0.05.
Results:
In all, 81 children were included in the study: 39 (48.1%) with KD (mean age 3.9 (SD 3.7) years; 23 boys (59%)), 29 (35.8%) with MIS-C (mean age 9.8 (SD 4.5) years; 16 boys (55.2%)) and 13 (16.1%) with TSS (mean age 11.3 (SD 5.2) years; 5 boys (38.5%)). The time from symptom onset to diagnosis was shorter in TSS compared with MIS-C and KD (p<0.001). Patients with MIS-C differ from those with KD, with more frequent gastrointestinal symptoms (e.g., abdominal pain, vomitting, diarrhoea), neurological manifestations (e.g., headache, meningism/photophobia, hyperaesthesia) and cardiac involvement at onset (i.e., valvular insufficiency, pericardial effusions, systolic dysfunction)(p<0.01). Meanwhile, cervical lymphadenopathy, synovitis and arthralgia were significantly more common in KD compared with MIS-C and TSS (p<0.05).
Conclusions/Learning Points:
Children with MIS-C display specific clinical features when compared with those with KD and TSS. The overlapping signs and symptoms of these childhood diseases make an appropriate diagnosis challenging.