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Review
. 2026 Jan 19:13:30502225251411149.
doi: 10.1177/30502225251411149. eCollection 2026 Jan-Dec.

Kawasaki Disease Versus Multisystem Inflammatory Syndrome in Children: Exploring the Complexities of Pediatric Cardiac Inflammatory Disorders

Dalia Safi  1 , Christophe El Rassi  1 , Maria Abou Mansour  1 , Bshara Sleem  1 , Issam El Rassi  2 , Mariam Arabi  3
Affiliations
Review

Kawasaki Disease Versus Multisystem Inflammatory Syndrome in Children: Exploring the Complexities of Pediatric Cardiac Inflammatory Disorders

Dalia Safi et al. Sage Open Pediatr. .

Abstract

Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) are both pediatric inflammatory conditions that pose significant challenges in diagnosis and management due to their overlapping clinical features and distinct pathophysiological profiles. KD is a well-established acute vasculitis that primarily affects children under 5. In contrast, MIS-C is a recently identified condition associated with SARS-CoV-2 infection, typically affecting older children and adolescents. Reported mortality for MIS-C remains below 2%, compared with less than 0.1% for KD, although both can result in significant cardiac morbidity if untreated. This review highlights the critical differences between KD and MIS-C, including their genetic underpinnings, clinical manifestations, and responses to treatment. While KD has a well-established treatment protocol involving intravenous immunoglobulin and aspirin, MIS-C treatment is still evolving. The manuscript underscores the importance of distinguishing between these conditions for accurate diagnosis and tailored treatment, which is crucial for improving patient outcomes.

Keywords: COVID-19; Kawasaki disease; SARS-CoV-2; coronary artery aneurysms; hyperinflammation; intravenous immunoglobulin; multisystem inflammatory syndrome in children.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

The world map depicts global distribution of KD and MIS-C with specific countries highlighted in different colors.
Figure 1.
Countries stratified based on reporting a relatively higher incidence of KD and MIS-C (created via BioRender Premium).
Comparison of KD and MIS-C with coronary artery changes depicted.
Figure 2.
Predominant coronary artery changes in KD (A) and MIS-C (B).
Comparison of clinical features in children with KD and MIS-C disease across body systems.
Figure 3.
Comparison of clinical features in KD and MIS-C Children across body systems (created via BioRender Premium).
See this image and copyright information in PMC

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