CASE REPORT article
Front. Pediatr.
Sec. Pediatric Immunology
This article is part of the Research TopicAdvances and Challenges in Pediatric Immune Disorders: From Pathogenesis to Personalized TherapyView all 6 articles
Kawasaki disease versus MIS-C in a child with congenital coronary artery anomaly: a case report
Provisionally accepted
- 1Ternopil State Medical University, Ternopil, Ukraine
- 2Ternopil Regional Children's Hospital, Ternopil, Ukraine
- 3Children’s Cardiology and Cardio-Surgery Center Ministry of Health of Ukraine, Kyiv, Ukraine
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C), associated with SARS-CoV-2 infection share overlapping clinical and laboratory features, making differential diagnosis particularly challenging during the COVID-19 pandemic. Accurate distinction is essential due to differences in pathophysiology, management strategies, and cardiovascular outcomes. We report the case of a 7-year-old boy presenting with prolonged fever, mucocutaneous manifestations, arthritis, and elevated inflammatory markers following SARS-CoV-2 exposure. The clinical course demonstrated features compatible with both incomplete Kawasaki disease and MIS-C. Laboratory findings and cardiac biomarkers showed a mixed profile, while echocardiography and coronary imaging revealed the development of coronary artery aneurysms. Notably, a complex congenital coronary artery anomaly was incidentally identified during coronary evaluation. Although such anomalies are not considered independent risk factors for coronary aneurysm formation, their presence may complicate the interpretation of coronary findings in the setting of systemic inflammation. The patient showed a rapid and sustained clinical response to systemic glucocorticoid therapy without intravenous immunoglobulin administration; however, coronary artery aneurysms subsequently developed. This case highlights the diagnostic and therapeutic challenges at the interface of KD and MIS-C and underscores the importance of an integrated, individualized approach that incorporates clinical evolution, laboratory data, and detailed coronary assessment.
Keywords: Coronary aneurysms, Coronary artery anomaly, kawasaki disease, MIS-C, SARS-CoV-2
Received: 15 Dec 2025; Accepted: 23 Jan 2026.
Copyright: © 2026 Boyarchuk, Zaleshchuk, Zaremba, Chubata and Morkovkina. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Oksana Boyarchuk
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.