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Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review.
Rheumatology (Oxford). 2021 10 02; 60(10):4530-4537.R

Abstract

OBJECTIVE

To better define the clinical distinctions between the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related paediatric inflammatory multisystem syndrome (PIMS) and Kawasaki disease (KD).

METHODS

We compared three groups of patients: group 1, cases from our national historic KD database (KD-HIS), before the SARS-CoV-2 pandemic; group 2, patients with KD admitted to an intensive care unit (KD-ICU) from both our original cohort and the literature, before the SARS-CoV-2 pandemic; and group 3, patients with PIMS from the literature.

RESULTS

KD-HIS included 425 patients [male:female ratio 1.3, mean age 2.8 years (s.d. 2.4)], KD-ICU 176 patients [male:female ratio 1.3, mean age 3.5 years (s.d. 3.1)] and PIMS 404 patients [male:female ratio 1.4, mean age 8.8 years (s.d. 3.7)]. As compared with KD-HIS patients, KD-ICU and PIMS patients had a higher proportion of cardiac failure, digestive and neurological signs. KD-ICU and PIMS patients also had a lower frequency of typical KD-mucocutaneous signs, lower platelet count, higher CRP and lower sodium level. As compared with KD-HIS and KD-ICU patients, PIMS patients were older and more frequently had myocarditis; they also had fewer coronary abnormalities and lower sodium levels. Unresponsiveness to IVIG was more frequent in KD-ICU than KD-HIS and PIMS patients.

CONCLUSION

On clinical grounds, KD-HIS, KD-ICU and PIMS might belong to a common spectrum of non-specific pathogen-triggered hyperinflammatory states. The causes of increasing inflammation severity within the three entities and the different effects on the heart remain to be determined.

Authors+Show Affiliations

Paediatric Rheumatology, APHP. CEREMAIA, French Reference Centre for Auto-Inflammatory Diseases and Inflammatory Amyloidosis, CHU Bicêtre, Le Kremlin-Bicêtre. University of Paris-Saclay, INSERM, UMR 1173, Infection and Inflammation, Montigny-Le-Bretonneux.Paediatric Rheumatology, APHP. CEREMAIA, French Reference Centre for Auto-Inflammatory Diseases and Inflammatory Amyloidosis, CHU Bicêtre, Le Kremlin-Bicêtre. University of Paris-Saclay.Paediatric Rheumatology, APHP.Paediatric Intensive Care Unit, APHP, CHU Robert Debré, Paris, France.CEREMAIA, French Reference Centre for Auto-Inflammatory Diseases and Inflammatory Amyloidosis, CHU Bicêtre, Le Kremlin-Bicêtre. University of Paris-Saclay. Paediatric Dermatology, CHU Sainte Justine Research Centre, University of Montreal, Montreal, Canada.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33493353

Citation

Cherqaoui, Bilade, et al. "Delineating Phenotypes of Kawasaki Disease and SARS-CoV-2-related Inflammatory Multisystem Syndrome: a French Study and Literature Review." Rheumatology (Oxford, England), vol. 60, no. 10, 2021, pp. 4530-4537.
Cherqaoui B, Koné-Paut I, Yager H, et al. Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review. Rheumatology (Oxford). 2021;60(10):4530-4537.
Cherqaoui, B., Koné-Paut, I., Yager, H., Bourgeois, F. L., & Piram, M. (2021). Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review. Rheumatology (Oxford, England), 60(10), 4530-4537. https://doi.org/10.1093/rheumatology/keab026
Cherqaoui B, et al. Delineating Phenotypes of Kawasaki Disease and SARS-CoV-2-related Inflammatory Multisystem Syndrome: a French Study and Literature Review. Rheumatology (Oxford). 2021 10 2;60(10):4530-4537. PubMed PMID: 33493353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review. AU - Cherqaoui,Bilade, AU - Koné-Paut,Isabelle, AU - Yager,Hélène, AU - Bourgeois,Fleur Le, AU - Piram,Maryam, PY - 2020/10/02/received PY - 2020/12/19/accepted PY - 2021/1/26/pubmed PY - 2021/10/12/medline PY - 2021/1/25/entrez KW - COVID-19 KW - Kawasaki disease KW - PIMS/MIS-C KW - SARS-CoV-2-related inflammatory multisystem syndrome KW - intensive care unit KW - intravenous immunoglobulins KW - shock syndrome KW - systemic vasculitis SP - 4530 EP - 4537 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 60 IS - 10 N2 - OBJECTIVE: To better define the clinical distinctions between the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related paediatric inflammatory multisystem syndrome (PIMS) and Kawasaki disease (KD). METHODS: We compared three groups of patients: group 1, cases from our national historic KD database (KD-HIS), before the SARS-CoV-2 pandemic; group 2, patients with KD admitted to an intensive care unit (KD-ICU) from both our original cohort and the literature, before the SARS-CoV-2 pandemic; and group 3, patients with PIMS from the literature. RESULTS: KD-HIS included 425 patients [male:female ratio 1.3, mean age 2.8 years (s.d. 2.4)], KD-ICU 176 patients [male:female ratio 1.3, mean age 3.5 years (s.d. 3.1)] and PIMS 404 patients [male:female ratio 1.4, mean age 8.8 years (s.d. 3.7)]. As compared with KD-HIS patients, KD-ICU and PIMS patients had a higher proportion of cardiac failure, digestive and neurological signs. KD-ICU and PIMS patients also had a lower frequency of typical KD-mucocutaneous signs, lower platelet count, higher CRP and lower sodium level. As compared with KD-HIS and KD-ICU patients, PIMS patients were older and more frequently had myocarditis; they also had fewer coronary abnormalities and lower sodium levels. Unresponsiveness to IVIG was more frequent in KD-ICU than KD-HIS and PIMS patients. CONCLUSION: On clinical grounds, KD-HIS, KD-ICU and PIMS might belong to a common spectrum of non-specific pathogen-triggered hyperinflammatory states. The causes of increasing inflammation severity within the three entities and the different effects on the heart remain to be determined. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/33493353/Delineating_phenotypes_of_Kawasaki_disease_and_SARS_CoV_2_related_inflammatory_multisystem_syndrome:_a_French_study_and_literature_review_ DB - PRIME DP - Unbound Medicine ER -