{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T18:46:54Z","timestamp":1782240414372,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fped.2026.1768080","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:34:37Z","timestamp":1771310077000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Kawasaki disease vs. MIS-C in a child with congenital coronary artery anomaly: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Oksana","family":"Boyarchuk","sequence":"first","affiliation":[{"name":"Department of Children\u2019s Diseases and Pediatric Surgery, Horbachevsky Ternopil National Medical University","place":["Ternopil, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta-Viktoriia","family":"Zaleshchuk","sequence":"additional","affiliation":[{"name":"Department of Children\u2019s Diseases and Pediatric Surgery, Horbachevsky Ternopil National Medical University","place":["Ternopil, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roksolana","family":"Zaremba","sequence":"additional","affiliation":[{"name":"Department of Children\u2019s Diseases and Pediatric Surgery, Horbachevsky Ternopil National Medical University","place":["Ternopil, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana","family":"Chubata","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology and Cardiorheumatology, Ternopil Regional Children\u2019s Hospital","place":["Ternopil, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Morkovkina","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ukrainian Children's Cardiac Center","place":["Kyiv, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.jpeds.2020.08.003","article-title":"Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: a systematic review","volume":"226","author":"Abrams","year":"2020","journal-title":"J Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1001\/jama.2021.2091","article-title":"Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19","volume":"325","author":"Feldstein","year":"2021","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1111\/jpc.12172","article-title":"Update on Kawasaki disease: epidemiology, aetiology and pathogenesis","volume":"49","author":"Yim","year":"2013","journal-title":"J Paediatr Child Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e70267","DOI":"10.1002\/iid3.70267","article-title":"The etiopathogenesis of Kawasaki disease: evolving understanding of diverse triggers","volume":"13","author":"Hara","year":"2025","journal-title":"Immun Inflamm Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1038\/s41577-020-0367-5","article-title":"Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children","volume":"20","author":"Rowley","year":"2020","journal-title":"Nat Rev Immunol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1093\/jpids\/piaa167","article-title":"Multisystem inflammatory syndrome in children in February 2020 and implications of genomic sequencing for SARS-CoV-2","volume":"10","author":"Parsons","year":"2021","journal-title":"J Pediatric Infect Dis Soc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1001\/jama.2020.10369","article-title":"PIMS-TS Study group and EUCLIDS and PERFORM consortia. 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