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Article Dans Une Revue Nature Reviews Rheumatology Année : 2021

Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison

Résumé

Children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are predominantly asymptomatic or have mild symptoms compared with the more severe coronavirus disease 2019 (COVID-19) described in adults. However, SARS-CoV-2 is also associated with a widely reported but poorly understood paediatric systemic vasculitis. This multisystem inflammatory syndrome in children (MIS-C) has features that overlap with myocarditis, toxic-shock syndrome and Kawasaki disease. Current evidence indicates that MIS-C is the result of an exaggerated innate and adaptive immune response, characterized by a cytokine storm, and that it is triggered by prior SARS-CoV-2 exposure. Epidemiological, clinical and immunological differences classify MIS-C as being distinct from Kawasaki disease. Differences include the age range, and the geographical and ethnic distribution of patients. MIS-C is associated with prominent gastrointestinal and cardiovascular system involvement, admission to intensive care unit, neutrophilia, lymphopenia, high levels of IFNγ and low counts of naive CD4+ T cells, with a high proportion of activated memory T cells. Further investigation of MIS-C will continue to enhance our understanding of similar conditions associated with a cytokine storm.
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Dates et versions

hal-03452607 , version 1 (27-11-2021)

Identifiants

Citer

Chetan Sharma, Madhusudan Ganigara, Caroline Galeotti, Joseph Burns, Fernando M Berganza, et al.. Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nature Reviews Rheumatology, 2021, 17 (12), pp.731-748. ⟨10.1038/s41584-021-00709-9⟩. ⟨hal-03452607⟩
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