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Children with Kawasaki disease or Kawasaki-like syndrome (MIS-C/PIMS) at the time of COVID-19: are they all the same? Case series and literature review.
Marino, A; Varisco, T; Quattrocchi, G; Amoroso, A; Beltrami, D; Venturiello, S; Ripamonti, A; Villa, A; Andreotti, M; Ciuffreda, M; Cimaz, R.
Afiliação
  • Marino A; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). achillemarino6@gmail.com.
  • Varisco T; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). t.varisco@asst-monza.it.
  • Quattrocchi G; Department of Pediatrics, Papa Giovanni XXIII Hospital, University of Milano-Bicocca, Bergamo. giulia.quattro28@gmail.com.
  • Amoroso A; Department of Pediatrics, Papa Giovanni XXIII Hospital, University of Milano-Bicocca, Bergamo. Angela.amoroso44@gmail.com.
  • Beltrami D; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). beltrami.db@gmail.com.
  • Venturiello S; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). silvia.venturiello@gmail.com.
  • Ripamonti A; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). annalisa.ripamonti@gmail.com.
  • Villa A; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). villa.alessia@virgilio.it.
  • Andreotti M; Department of Pediatrics, Desio Hospital, ASST Monza, (MB). m.andreotti@hsgerardo.org.
  • Ciuffreda M; Department of Cardiology, Papa Giovanni XXIII Hospital, Bergamo. mciuffreda@asst-pg23.it.
  • Cimaz R; ASST G. Pini-CTO, Milan, Italy; Department of Clinical Sciences and Community Health, and Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan. rolando.cimaz@unimi.it.
Reumatismo ; 73(1): 48-53, 2021 Apr 19.
Article em En | MEDLINE | ID: mdl-33874647
Since the coronavirus disease 2019 (COVID-19) outbreak started, children have been considered marginally involved compared to adults, with a quite significant percentage of asymptomatic carriers. Very recently, an overwhelming inflammatory activation, which shares clinical similarities with Kawasaki disease (KD), has been described in children exposed to COVID-19. We report three KD-like cases that occurred during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a highly affected area of Northern Italy. The clinical presentation was characterized by the presence of unremitting fever, diarrhea and elevated inflammatory markers. Case #1 and Case #2 occurred one week apart and shared other clinical features: laboratory tests confirmed COVID-19 exposure and high inflammatory activation with myocardial involvement. Case #3 followed a more typical pattern for KD. Interestingly, this patient showed lower levels of procalcitonin, C-reactive protein, D-dimers, and ferritin compared to the other two cases, whereas platelet count was higher. We hypothesize that SARS-CoV-2 might act in children as a trigger, either inducing a classical KD phenotype or causing a systemic inflammatory response leading to a severe KD-like phenotype, eventually characterized by myocardial impairment. We think that bringing these cases and their differences to the attention of the rheumatology community during the COVID-19 pandemic will be beneficial in order to highlight the importance of early diagnosis and to increase awareness of this new phenomenon.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome de Resposta Inflamatória Sistêmica / COVID-19 / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies / Screening_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome de Resposta Inflamatória Sistêmica / COVID-19 / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies / Screening_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article