Convergence and divergence in Kawasaki disease and multisystem inflammatory syndrome in children: results from the COVASAKI survey.

Autor:	Mastrolia MV; Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Firenze, and NEUROFARBA Department, University of Florence, Italy. maria.mastrolia@unifi.it., Martini M; Paediatric Unit, San Donato Hospital, Arezzo, Italy., Memmini G; Division of Neonatology and Paediatrics, Apuane Hospital, Massa Carrara, AUSL Toscana Nord Ovest, Pisa, Italy., Ferrara G; Paediatric Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, AUSL Toscana Centro, Firenze, Italy., Bernardini R; Paediatric Unit, San Giuseppe Hospital, Empoli, Italy., Peroni D; Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Italy., Consolini R; Section of Clinical and Laboratory Immunology, Department of Clinical and Experimental Medicine, University of Pisa, Italy., Marrani E; Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Firenze, Italy., Agostiniani R; Paediatric Unit, San Jacopo Hospital, Pistoia, Italy., Maccora I; Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Firenze, and NEUROFARBA Department, University of Florence, Italy., Falorni S; Paediatric Unit, Misericordia Hospital, Grosseto, Italy., Azzari C; Paediatric Immunology Unit, Meyer Children's Hospital IRCCS, Firenze; and Department of Health Sciences, University of Florence, Italy., Calabri GB; Cardiology Unit, Meyer Children's Hospital IRCCS, Firenze, Italy., Pagnini I; Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Firenze, Italy., Indolfi G; NEUROFARBA Department, University of Florence, and Paediatric Unit, Meyer Children's Hospital IRCCS, Firenze, Italy., L'Erario M; Paediatric Intensive Care Unit, Meyer Children's Hospital IRCCS, Firenze, Italy., Trapani S; Department of Health Sciences, University of Florence, and Paediatric Unit, Meyer Children's Hospital IRCCS, Firenze, Italy., Simonini G; Rheumatology Unit, ERN ReCONNET Center, Meyer Children's Hospital IRCCS, Firenze, and NEUROFARBA Department, University of Florence, Italy.
Jazyk:	angličtina
Zdroj:	Clinical and experimental rheumatology [Clin Exp Rheumatol] 2024 Apr; Vol. 42 (4), pp. 931-936. Date of Electronic Publication: 2024 Apr 29.
DOI:	10.55563/clinexprheumatol/l64q51
Abstrakt:	Objectives: To compare Kawasaki disease (KD) and multisystem inflammatory syndrome (MIS-C) in children. Methods: Prospective collection of demographics, clinical and treatment data. Assessment of type 1 interferon (IFN) score, CXCL9, CXCL10, Interleukin (IL)18, IFNγ, IL6, IL1b at disease onset and at recovery. Results: 87 patients (43 KD, 44 MIS-C) were included. Age was higher in MIS-C compared to KD group (mean 31±23 vs. 94±50 months, p<0.001). Extremities abnormalities (p=0.027), mucosal involvement (p<0.001), irritability (p<0.001), gallbladder hydrops (p=0.01) and lymphadenopathy (p=0.07) were more often recorded in KD. Neurological findings (p=0.002), gastrointestinal symptoms (p=0.013), respiratory involvement (p=0.019) and splenomegaly (p=0.026) were more frequently observed in MIS-C. Cardiac manifestations were higher in MIS-C (p<0.001), although coronary aneurisms were more frequent in KD (p=0.012). In the MIS-C group, the multiple linear regression analysis revealed that a higher IFN score at onset was related to myocardial disfunction (p<0.001), lymphadenopathy (p=<0.001) and need of ventilation (p=0.024). Both CXCL9 and CXCL10 were related to myocardial disfunction (p<0.001 and p=0.029). IL18 was positively associated to PICU admission (0.030) and ventilation (p=004) and negatively associated to lymphadenopathy (0.004). IFNγ values were related to neurological involvement and lymphadenopathy (p<0.001), IL1b to hearth involvement (0.006). A negative correlation has been observed between IL6 values, heart involvement (p=0.013) and PICU admission (p<0.001). Conclusions: The demographic and clinical differences between KD e MIS-C cohorts confirm previous reported data. The assessment of biomarkers levels at MIS-C onset could be useful to predict a more severe disease course and the development of cardiac complications.
Databáze:	MEDLINE
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