Rady Re-Evaluating Recent Kawasaki Cases For New Pediatric Illness Tied To Coronavirus
Friday, May 15, 2020
Credit: Kawasaki Research Foundation
San Diego's Children's Hospital is reviewing patients it recently treated for Kawasaki disease to determine if they were actually suffering from a similar but rare new illness connected to the novel coronavirus.
Doctors around the world, often in regions hit hardest by the pandemic, have reported cases of a pediatric inflammatory illness that can affect multiple organs, including the heart. The condition is like Kawasaki disease, which causes inflammation of the blood vessels but is appearing in children who have had some form of exposure to the SARS-CoV-2 virus.
Initially, the disease was dubbed pediatric inflammatory multisystem syndrome, or PIMS — although some organizations referred to it as pediatric multisystem inflammatory syndrome — but a May 14 health alert from the Centers for Disease Control warned about the multisystem inflammatory syndrome in children, or MIS-C.
Dr. Jane Burns, director of the Kawasaki Disease Clinic at Rady Children's Hospital, said while the new illness is concerning, especially because children were believed to be largely spared by COVID-19, most patients recover.
"The really bright news here is that the children with this very serious heart condition are responding very well, most of them, to treatment with intravenous immunoglobulin, which is what we use to treat Kawasaki disease, and they may require some steroids or some other anti-inflammatory medicines, but the heart muscle does seem to recover very quickly," said Burns, who also oversees the Kawasaki Disease Research Center at UC San Diego in partnership with Rady.
Patients have either tested positive for COVID-19 or their parent is confirmed or suspected of having the disease caused by the novel coronavirus, Burns said. Symptoms include persistent fever, abdominal pain along with diarrhea or vomiting and patients may also experience a rash or other physical signs that are common with Kawasaki disease, such as bloodshot eyes, swollen hands and feet and an enlarged lymph node in the neck.
New York State posted online it was investigating just more than 100 cases of the illness and three deaths. A children's hospital in Los Angeles reported on its website it treated three patients with the new condition and recently confirmed a fourth, the local NBC station reported. According to CNN, cases have been reported in at least 18 states and clusters have occurred in France, Italy and United Kingdom, where the illness was first identified.
Medical professionals so far are unsure what causes the new illness but Burns said one hypothesis is PIMS or MIS-C may actually be a form of Kawasaki disease that was triggered by COVID. Researchers are also still uncertain about what causes Kawasaki syndrome.
"We're trying to piece together all the bits of this puzzle, but it would seem to us that the exposure to the virus and the immune response that a genetically susceptible child makes could be one of perhaps many triggers for Kawasaki disease," Burns said.
Burns said there hasn’t been a local case but Rady treats about 80 to 100 Kawasaki cases each year and is reviewing patients since January to assess if any were the new illness. She said her team applied for a federal grant to study the new syndrome and she urged parents of PIMS or MIS-C patients to donate blood samples for research.
To view PDF documents, Download Acrobat Reader.