• Yi-Fang Wang, Chun-Min Fu, Kun-Lang Wu, Yi-Chin Peng, Yu-Hsuan Chien, Chi-Nan Huang, Ming-Chun Yang, Li-Chuan Sun, Chia-Yi Chin, Chee-Yew Lee, Yi-Ching Liu, Yi-Hsuan Su, Hing-Ka Lim, Hsin-Min Liu, Kuan-Ying A Huang, Ting-Yu Yen, Ching-Chia Wang, Chun-An Chen, Shuenn-Nan Chiu, En-Ting Wu, Chun-Yi Lu, Frank Leigh Lu, Luan-Yin Chang, Chun-Wei Lu, Jong-Min Chen, Ping-Ing Lee, Li-Min Huang, Jou-Kou Wang, Mei-Hwan Wu, Ming-Tai Lin, and for Taiwan KD Research Network.
• Department of Pediatrics, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
• J Formos Med Assoc. 2024 Nov 1; 123 (11): 113111381131-1138.

ObjectivesThis study aimed to identify clinical characteristics to differentiate multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in Taiwan, an island with a delayed cluster of MIS-C and a high incidence of KD. Additionally, we studied risk factors for developing severe complications in patients with MIS-C.MethodsWe conducted a retrospective, multicenter, cohort, and observational study that linked data on patients with MIS-C between May and December 2022 and patients with KD between 2019 and 2021 from 12 medical centers. Hemodynamic compromise, defined as the need for inotropic support or fluid challenge, was recorded in patients with MIS-C. We also evaluated maximal coronary Z-scores before treatment and one month after disease onset.ResultsA total of 83 patients with MIS-C and 466 patients with KD were recruited. A 1:1 age and gender-matched comparison of 68 MIS-C and KD pairs showed that MIS-C patients had a lower percentage of positive BCG red halos, lower leukocyte/platelet counts, more gastrointestinal symptoms, and a higher risk of hemodynamic compromise. In Taiwan, 38.6% of MIS-C patients experienced hemodynamic compromise, with presence of conjunctivitis and elevated levels of procalcitonin (>1.62 ng/mL) identified as independent risk factors.ConclusionWe identified two independent risk factors associated with hemodynamic compromise in MIS-C patients. The comparison between matched MIS-C and KD patients highlighted significant differences in clinical presentations, like BCG red halos, which may aid in the differential diagnosis of the two disease entities, especially in regions with a high incidence rate of KD.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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