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Convergence and divergence in Kawasaki disease and multisystem inflammatory syndrome in children: results from the COVASAKI survey.
Mastrolia, Maria Vincenza; Martini, Marco; Memmini, Graziano; Ferrara, Giovanna; Bernardini, Roberto; Peroni, Diego; Consolini, Rita; Marrani, Edoardo; Agostiniani, Rino; Maccora, Ilaria; Falorni, Susanna; Azzari, Chiara; Calabri, Giovanni Battista; Pagnini, Ilaria; Indolfi, Giuseppe; L'Erario, Manuela; Trapani, Sandra; Simonini, Gabriele.
Afiliación
  • 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.
Clin Exp Rheumatol ; 42(4): 931-936, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38683206
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Respuesta Inflamatoria Sistémica / COVID-19 / Síndrome Mucocutáneo Linfonodular Límite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Clin Exp Rheumatol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Respuesta Inflamatoria Sistémica / COVID-19 / Síndrome Mucocutáneo Linfonodular Límite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Clin Exp Rheumatol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia