COVID-19-associated multisystem inflammatory syndrome differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
COVID-19-associated multisystem inflammatory syndrome must be differentiated from other diseases that cause conjunctival injection, cervical lymphadenopathy, and erythematous hands and feet, such as Kawasaki's disease and toxic shock syndrome.
Differentiating COVID-19-associated multisystem inflammatory syndrome Disease from other disease
- COVID-19-associated multisystem inflammatory syndrome must be differentiated from other diseases that cause conjunctival injection, cervical lymphadenopathy, and erythematous hands and feet, such as Kawasaki's disease and toxic shock syndrome.[1][2]
| Parameters | COVID-19-associated multisystem inflammatory syndrome (PIMS-TS) | Kawasaki Disease (KD) | Kawasaki Disease Shock (KDS) | Toxic Shock Syndrome (TSS) | Viral Pneumonia[3] |
|---|---|---|---|---|---|
| Age (median, IQR) | 9 (5.7-14) | 2.7 (1.4-4.7) | 3.8 (0.2-18) | 7.38 (2.4-15.4) | < 5 years |
| Total white blood cell count (*10^9/L) | 17 (12-22) | 13.4 (10.5-17.3) | 12.1 (7.9-15.5) | 15.6 (7.5-20) | 10.0 |
| Neutrophil count (*10^9/L) | 13 (10-19) | 7.2 (5.1-9.9) | 5.5 (3.2-10.3) | 16.4 (12-22) | 3.2 (1.0-5.1) |
| Lymphocyte count (*10^9/L) | 0.8 (0.5-1.5) | 2.8 (1.5-4.4) | 1.6 (1-2.5) | 0.63 (0.41, 1.13) | 4.5 (2.7-6.1) |
| Hemoglobin (g/L) | 92 (83-103) | 111.0 (105-119) | 107 (98-115) | 114 (98-130) | - |
| Platelet number (10^9/L) | 151 (104-210) | 365.0 (288-462) | 235 (138-352) | 155 (92- 255) | 387 (+/-174) |
| C-reactive protein (mg/L) | 229 (156-338) | 67.0(40-150) | 193 (83-237) | 201 (122, 317) | 3.4 (0.2-29) |
| ALT (IU/L) | 42 (26-95) | 42.0 (24-112) | 73 (34-107) | 30.00 (22.10, 49.25) | - |
| Albumin (g/L) | 24 (21-27) | 38.0 (35-41) | 30 (27-35) | 27.00 (21.00, 31.00) | - |
| Ferritin (ug/L) | 610 (359-1280) | 200 (143-243) | 301 (228-337) | - | - |
| NT-Pro-BNP (pg/ml) | 788 (174-10548) | 41 (12-102) | 396 (57-1520) | - | - |
| Troponin (ng/L) | 45 (8-294) | 10.0 (10-20) | 10 (10-30) | - | - |
| D-dimer (ng/ml) | 3578 (2085- 8235) | 1650 (970-2660) | 2580 (1460- 2990) | - | - |
- To view the differential diagnosis of COVID-19, click here.
References
- ↑ 1.0 1.1 Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P; et al. (2020). "Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2". JAMA. doi:10.1001/jama.2020.10369. PMC 7281356 Check
|pmc=value (help). PMID 32511692 Check|pmid=value (help). - ↑ Cheung EW, Zachariah P, Gorelik M, Boneparth A, Kernie SG, Orange JS; et al. (2020). "Multisystem Inflammatory Syndrome Related to COVID-19 in Previously Healthy Children and Adolescents in New York City". JAMA. doi:10.1001/jama.2020.10374. PMC 7281352 Check
|pmc=value (help). PMID 32511676 Check|pmid=value (help). - ↑ Ruuskanen O, Lahti E, Jennings LC, Murdoch DR (2011). "Viral pneumonia". Lancet. 377 (9773): 1264–75. doi:10.1016/S0140-6736(10)61459-6. PMC 7138033 Check
|pmc=value (help). PMID 21435708.