Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve.
D, L., S, Š., D, D., N, K., K, B., H, K., & L, S.M. (2026). Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve.. The Pediatric infectious disease journal. https://doi.org/10.1097/INF.0000000000005208
D L, S Š, D D, N K, K B, H K, et al. Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve.. The Pediatric infectious disease journal. 2026; doi: 10.1097/INF.0000000000005208
D L, S Š, D D, et al. Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve.[J]. The Pediatric infectious disease journal. 2026. DOI: 10.1097/INF.0000000000005208.
@article{d2026,
author = {Ljubas D and Šiftar S and Didović D and Krajcar N and Bodulić K and Kniewald H and Stemberger Marić L},
title = {Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve.},
journal = {The Pediatric infectious disease journal},
year = {2026},
doi = {10.1097/INF.0000000000005208},
note = {PMID: 42403251},
}
TY - JOUR AU - Ljubas D AU - Šiftar S AU - Didović D AU - Krajcar N AU - Bodulić K AU - Kniewald H AU - Stemberger Marić L TI - Model-based Differentiation Between Kawasaki Disease and MIS-C: The Importance of the Mitral Valve. T2 - The Pediatric infectious disease journal PY - 2026 DO - 10.1097/INF.0000000000005208 AN - PMID:42403251 ER -
BACKGROUND: Due to increasing proportion of asymptomatic severe acute respiratory syndrome coronavirus 2 infections and previously reported overlapping features, the distinction between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) remains challenging. Statistical differentiation models for clinical guidance are scarce and should focus on cardiac involvement, as differences in cardiac involvement might serve as a potential clinical finding for early recognition of MIS-C. METHODS: We retrospectively analyzed 298 MIS-C and KD cases treated during the 22-year period (from 2003 to 2024), and compared demographic, clinical, laboratory, ultrasound and cardiac findings. A multivariable differentiation model based on clinical, laboratory, ultrasound and cardiac features was developed for distinguishing KD/MIS-C cases. RESULTS: Of 298 cases, 162 (54.4%) were diagnosed with KD. MIS-C patients were significantly older (109.1 vs. 45.5 months, P < 0.001) and had higher admission rates to the intensive care unit (52.2% vs. 29.0%, P < 0.001). Rash (P < 0.001), conjunctivitis (P = 0.013), mucosal (P < 0.001) and extremity changes (P < 0.001) were more common in KD, while gastrointestinal symptoms were more common in MIS-C (P < 0.001). MIS-C patients also had higher C-reactive protein values (P < 0.001). Pericarditis, congestive heart failure and mitral regurgitation (P < 0.001) were more common in MIS-C patients. Based on our model, older age, higher C-reactive protein values, gastrointestinal symptoms, hyponatremia, presence of ascites and mitral regurgitation were predictive of MIS-C. CONCLUSIONS: Our model is the first to report mitral regurgitation as a potential diagnostic hallmark for MIS-C. Comprehensive clinical, laboratory and ultrasound evaluation of patients with overlapping features of KD/MIS-C improves diagnostic yield. Future models should increase sample size and focus on external model validation.