What is the difference between MIS-C and Kawasaki disease?Experts analyze symptoms, treatment, and age of onset

Well-known Internet celebrities Rice & Shine have four lovely children, but after the family returned to Taiwan from a trip to South Africa, the second son suddenly had a high fever and was finally diagnosed with “Kawasaki’s disease”. In fact, some symptoms of Kawasaki disease and MIS-C are somewhat similar, and they are often used as a comparison. What is the difference between the two diseases? Domestic pediatricians said: “MIS-C and Kawasaki’s disease have many blurred boundaries, but there are still differences in the age of onset and affected systems.”

MIS-C may be an extreme form of Kawasaki disease

MIS-C is the so-called “Multisystem Inflammatory Syndrome in Children”. 2-6 weeks after children are infected with the new coronavirus, the damage caused by the multisystem inflammatory reaction occurs. Sustained and high-intensity inflammatory response, causing damage to various organ systems in the body. According to foreign statistics, the mortality rate of MIS-C is about 1-2%.

When it comes to MIS-C, the disease is often compared with Kawasaki disease. Professor Xie Kaisheng, deputy director of the Congenital Heart Disease and Ultrasound Center of the Children’s Hospital of Traditional Chinese Medicine, explained: “MIS-C may be an extreme form of Kawasaki disease. One to two-thirds of MIS-C cases have a Kawasaki-like phenomenon, and the other one-third are less so, combined with other systemic effects.”

Kawasaki syndrome: overt symptoms, with obvious skin and mucous membrane symptoms, cardiovascular damage, and older children
MIS-C: more insidious organ inflammation, after the onset, it will cause inflammation of internal organs such as liver, kidney and heart, and is more common in younger children

“Kawasaki’s disease will cause rashes and damage the coronary arteries. MIS-C is not as severe as Kawasaki’s disease after high fever, but it will cause severe multiple organ damage, severe and even shock. The two are different.” Xie Kaisheng explained.

MIS-C causes inflammation all over the body!Wider range of influence

Because MIS-C and Kawasaki disease have many blurred boundaries, sometimes it is not so easy for doctors to make a distinction. Peng Yiqin, an attending physician at the Department of Pediatric Cardiology at the Children’s Hospital of Traditional Chinese Medicine, mentioned: “MIS-C usually occurs in the comparative Older children, from 7 to 8 years old, may be in their teens, but most of Kawasaki’s patients are under 5 years old, mainly 3 years old.”

Kawasaki’s disease is relatively localized inflammation, such as blood vessels, coronary arteries, and eye blood vessels; MIS-C is multi-system inflammation, not only blood vessels include blood coagulation function, lymph nodes, and systemic systems, but the scope is wider, especially in blood tests. Differences, children suffering from MIS-C, the number of lymphocytes and platelets will be reduced.

Peng Yiqin has just recently admitted a MIS-C case, a 4-year-old girl who was diagnosed with the new coronavirus at the end of May. She suddenly developed a fever on June 20, and the right cervical lymph glands swelled the next day. After seeking medical treatment, the high fever continued. There were rashes on the trunk, redness of the conjunctiva, and a sharp increase in the inflammation index. The condition worsened and there was shock at one point. Fortunately, he was discharged smoothly on the 11th day of hospitalization after treatment.

Children with MIS-C!Most heart function returns within two months

It is suggested in the literature that if you have been infected with new coronary pneumonia and have Kawasaki’s disease, it is recommended to treat it with MIS-C. The difference between the two is not easy to distinguish. Fortunately, the treatment of the two diseases is somewhat similar, but the steroids must be given at the same time. Or give separately.

The process of treating MIS-C is very difficult, especially the parents will be very worried. Peng Yiqin said: “Every time I have to sign a consent form in critical condition, it will cause a great shock to the parents. Fortunately, the prognosis of these children is good after discharge.” According to the literature statistics of heart function It will recover within two months, and the heart inflammation indicators will also recover within two months. Only the coronary artery is affected. It may require long-term follow-up and aspirin, but most of them can return to normal life.

Xie Kaisheng reminded parents: “Although MIS-C occurs more often in older children, there are still 20 to 30% of children with Kawasaki disease at the same age. Therefore, regardless of age, after infection with the new coronavirus, continue to observe the child’s fever. Symptoms, such as swollen lymph nodes, rashes, and gastrointestinal symptoms, it is recommended to seek medical attention.”