Castaldo Alice, D'Anna Carolina, Gelzo Monica, Giannattasio Antonietta, Maglione Marco, Muzzica Stefania, Raia Maddalena, Scalia Giulia, Tripodi Lorella, Castaldo Giuseppe, Tipo Vincenzo, Grieco Domenico, Grieco Michela
Dipartimento Di Scienze Mediche Traslazionali, Sezione Di Pediatria, Università Di Napoli Federico II, Naples, Italy.
Dipartimento Di Emergenza, AORN Santobono-Pausilipon, Naples, Italy.
Transl Med Commun. 2022;7(1):22. doi: 10.1186/s41231-022-00128-2. Epub 2022 Sep 4.
The pathogenesis of the novel described multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) is still debated as it is not clear if they are the same or different nosological entities. However, for both the diseases a rapid and unequivocal diagnosis is mandatory to start the therapy before the onset of severe complications. In this study, we aimed to evaluate the white cell populations in MIS-C and KD as potential markers to discriminate between the two diseases.
We studied white cell populations by flow cytometry in 46 MIS-C and 28 KD patients in comparison to 70 age-matched healthy children.
MIS-C patients had a significant lymphopenia that involved both B and T populations while KD patients showed a significant neutrophilia and thrombocythemia. Granulocyte/lymphocyte ratio helped to diagnose both MIS-C and KD with a high diagnostic sensitivity, while a multivariate analysis of granulocyte and T lymphocyte number contributed to discriminate between the two diseases.
The relevant lymphopenia observed in MIS-C patients suggests that the disease would be a post-infectious sequel of COVID-19 immunologically amplified by a massive cytokine release, while the significant neutrophilia and thrombocythemia observed in KD confirmed that the disorder has the genesis of a systemic vasculitis. The analysis of a panel of circulating cells may help to early diagnose and to discriminate between the two diseases.
The online version contains supplementary material available at 10.1186/s41231-022-00128-2.
新型儿童多系统炎症综合征（MIS-C）和川崎病（KD）的发病机制仍存在争议，因为它们是否为同一或不同的疾病实体尚不清楚。然而，对于这两种疾病，快速明确的诊断对于在严重并发症发生前开始治疗至关重要。在本研究中，我们旨在评估MIS-C和KD患者的白细胞群体，作为区分这两种疾病的潜在标志物。
我们通过流式细胞术研究了46例MIS-C患者、28例KD患者以及70例年龄匹配的健康儿童的白细胞群体。
MIS-C患者存在显著的淋巴细胞减少，累及B细胞和T细胞群体，而KD患者表现出显著的中性粒细胞增多和血小板增多。粒细胞/淋巴细胞比值有助于以高诊断敏感性诊断MIS-C和KD，而对粒细胞和T淋巴细胞数量的多变量分析有助于区分这两种疾病。
MIS-C患者中观察到的显著淋巴细胞减少表明，该疾病可能是由大量细胞因子释放免疫放大的COVID-19感染后后遗症，而KD患者中观察到的显著中性粒细胞增多和血小板增多证实该疾病起源于系统性血管炎。对一组循环细胞的分析可能有助于早期诊断和区分这两种疾病。
在线版本包含可在10.1186/s41231-022-00128-2获取的补充材料。
