The clinical manifestation and diagnostic features of Kawasaki-like phenotypes in pediatric multisystem inflammatory syndrome: a comparative retrospective study in Ukraine.

IF 2.1 3区 医学 Q2 PEDIATRICS
Frontiers in Pediatrics Pub Date : 2025-07-03 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1593190
Nataliia Bodnarchuk-Sokhatska, Halyna Pavlyshyn, Kateryna Kozak, Iryna Avramenko
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引用次数: 0

Abstract

Background: The clinical overlap syndrome between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD), particularly in the context of SARS-CoV-2 infection, presents diagnostic challenges. The presence of both complete and incomplete Kawasaki-like phenotypes (KLP) further complicates differentiation. This study aimed to analyze Kawasaki-like phenotype of MIS-C, its clinical features, and improve diagnostic accuracy, patient outcomes.

Methods: A retrospective cohort study was conducted on 48 pediatric patients diagnosed with MIS-С between 2020 and 2022. All cases met the MIS-C diagnostic criteria established by the Council of State and Territorial Epidemiologists (2022) and were classified according to the American Heart Association Kawasaki disease criteria (2017). Patients were grouped as non-Kawasaki-like or Kawasaki-like MIS-C phenotypes, with the latter subdivided into complete and incomplete subtypes. Clinical and echocardiographic features were compared using appropriate statistical methods.

Results: Among the 48 MIS-C cases analyzed, 22 patients (46%) met the Kawasaki disease criteria, equally divided between complete and incomplete Kawasaki-like phenotypes. btion was longest in the complete phenotype (9.7 days) and shortest in the incomplete phenotype (5.5 days). Patients with neurological involvement experienced longer febrile periods (8.3 vs. 5.4 days). All 100% patients with the complete phenotype exhibited neurological symptoms vs. 46% of incomplete cases. Half of the Kawasaki-like phenotype patients demonstrated echocardiographic abnormalities vs. 15% of non-Kawasaki-like (NKL); highest in the incomplete phenotype (91%) compared to 15% in non-Kawasaki-like and 9% in complete KLP. The highest incidence of coronary dilatation was recorded in the incomplete phenotype (73%) vs. 9% in the complete and 15% in the non-Kawasaki-like MIS-C.

Discussion: Kawasaki-like MIS-C phenotypes display distinct clinical and cardiovascular profiles. Accurate phenotypic identification is crucial for risk stratification and optimizing patient management. Further research is necessary to refine classification criteria and establish effective long-term monitoring strategies for affected children.

小儿多系统炎症综合征的川崎样表型的临床表现和诊断特点:乌克兰的一项比较回顾性研究。
背景:儿童多系统炎症综合征(MIS-C)与川崎病(KD)之间的临床重叠综合征,特别是在SARS-CoV-2感染的背景下,提出了诊断挑战。完全和不完全川崎样表型(KLP)的存在进一步使分化复杂化。本研究旨在分析misc的川崎样表型及其临床特征,以提高诊断准确性和患者预后。方法:对2020年至2022年诊断为MIS-С的48例儿科患者进行回顾性队列研究。所有病例均符合州和地区流行病学家委员会(2022年)制定的misc诊断标准,并根据美国心脏协会川崎病标准(2017年)进行分类。将患者分为非川崎样或川崎样misc表型,后者细分为完全亚型和不完全亚型。采用适当的统计学方法对临床和超声心动图特征进行比较。结果:在分析的48例misc病例中,22例(46%)符合川崎病标准,平均分为完全和不完全川崎样表型。Btion在完全表型中最长(9.7 d),在不完全表型中最短(5.5 d)。神经系统受累患者的发热期较长(8.3天对5.4天)。所有100%表型完整的患者都表现出神经系统症状,而46%的不完整病例表现出神经系统症状。一半的川崎样表型患者表现出超声心动图异常,而15%的非川崎样表型(NKL);不完全表型最高(91%),而非川崎样型为15%,完全KLP为9%。不完全表型的冠状动脉扩张发生率最高(73%),完全型为9%,非川崎样misc为15%。讨论:川崎样misc表型表现出不同的临床和心血管特征。准确的表型鉴定对于风险分层和优化患者管理至关重要。需要进一步研究以完善分类标准并为受影响儿童制定有效的长期监测战略。
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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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