Is it Kawasaki shock syndrome, Kawasaki-like disease or pediatric inflammatory multisystem disease? The importance of semantic in the era of COVID-19 pandemic

RMD Open. 2020 Jun;6(2):e001333. doi: 10.1136/rmdopen-2020-001333.


A few weeks after the peak of the global 2019 novel coronavirus disease pandemic, cases of shock, multisystem inflammation and severe myocarditis have occurred in children and adolescents, generating some concerns and above all many questions. An almost immediate association raised with shock syndrome related to Kawasaki disease (KD). However, in light of bo/th experience and literature have taught us about severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, and what already known on the epidemiology of KD, we suggest here the hypothesis of a new 'post-viral' systemic inflammatory disease related to excessive adaptive immune response rather than a form of KD caused by SARS-COV-2. We discuss analogies and differences between the two forms.

Keywords: Arthritis; Behcet Syndrome; Juvenile; Systemic vasculitis.

Publication types

  • Review

MeSH terms

  • Betacoronavirus / isolation & purification
  • COVID-19
  • Child
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / immunology
  • Coronavirus Infections* / physiopathology
  • Diagnosis, Differential
  • Disease Management
  • Humans
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Mucocutaneous Lymph Node Syndrome* / epidemiology
  • Mucocutaneous Lymph Node Syndrome* / immunology
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / immunology
  • Pneumonia, Viral* / physiopathology
  • SARS-CoV-2
  • Systemic Vasculitis* / immunology
  • Systemic Vasculitis* / physiopathology
  • Systemic Vasculitis* / therapy
  • Terminology as Topic