Can Kawasaki disease be managed?

Marshall University, Charleston, WV, USA.
The Permanente journal 06/2012; 16(2):70-2.
Source: PubMed


Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but management of KD has received relatively little attention. In the US alone, about 5500 cases were estimated in 2009. KD is most common among Asian and Pacific Islander children but can affect all ethnicities and races. Timely and accurate diagnosis remains critical, but difficult: the etiology of KD is unknown, and no accurate diagnostic laboratory test has been developed. Continuing medical education can help physicians, clinicians, and nurse practitioners accurately diagnose and treat KD. A registry specific to KD or a surveillance system may be necessary to increase awareness among health care professionals and to decrease complications related to misdiagnosis.

Download full-text


Available from: Doohee Lee, Nov 04, 2014
  • Source
    • "IVIG resistance is problematic because recalcitrant fever is indicative of ongoing arteritis, which places patients at a higher risk of developing coronary artery aneurysms [39]. It is recommended that refractory disease is first treated with a second dose of IVIG 2 g/kg, though the efficacy of a number of other therapeutic options, including intravenous corticosteroid pulse therapy, anti-TNF-alpha antibodies, and cytotoxic agents, is an ongoing area of research [8, 11, 59]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aims. Kawasaki disease is an acute systemic vasculitis and is the most common cause of acquired heart disease in children in the developed world. This review aims to synthesise recent insights into the disease and provide an update for clinicians on diagnostic and treatment practices. Methods. We conducted a review of the literature exploring epidemiology, aetiology, diagnosis, and management of Kawasaki disease. We searched MEDLINE, Medline In-Process, Embase, Google Scholar, and reference lists of relevant articles. Conclusions. Kawasaki disease is a febrile vasculitis which progresses to coronary artery abnormalities in 25% of untreated patients. The disease is believed to result from a genetically susceptible individual's exposure to an environmental trigger. Incidence is rising worldwide, and varies widely across countries and within different ethnic groups. Diagnosis is based on the presence of fever in addition to four out of five other clinical criteria, but it is complicated by the quarter of the Kawasaki disease patients with “incomplete” presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves clinical outcomes and reduces the incidence of coronary artery dilation to less than 5%. Given its severe morbidity and potential mortality, Kawasaki disease should be considered as a potential diagnosis in cases of prolonged paediatric fever.
    International Journal of Pediatrics 10/2013; 2013(6):645391. DOI:10.1155/2013/645391
  • Source
    • "Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an acute self-limiting vasculitis of childhood.1 Kawasaki disease surpassed rheumatic fever as the most common cause of acquired heart disease. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Kawasaki disease is an acute self-limiting vasculitis that affects children. The most dreaded complication of Kawasaki disease reported in the literature over the years is coronary artery disease, which is considered as the main cause of acquired heart disease. However, pulmonary associations with Kawasaki disease have been overlooked. We present a rare, if not unique, case of Kawasaki disease associated with group A streptococcus pleural effusion in the English language literature. A search of the PubMed database was carried out, using a combination of the terms “Kawasaki disease”, “pneumonia”, and “group A streptococcus”. The majority of studies conducted in children with Kawasaki disease have concentrated on the coronary artery implications. Kawasaki disease is considered a self-limiting illness, but can have detrimental consequences if not diagnosed early. When there is a prolonged inflammatory reaction, with no infectious agent identified or remittent fever unresponsive to antibiotics, Kawasaki disease should be taken into consideration. Elevated Vβ2+ T cells compared with healthy controls suggest possible involvement of a superantigen in the etiology of Kawasaki disease, so it is wise that the health care provider concentrates not only on the cardiac consequences, but also on pulmonary associations.
    International Journal of General Medicine 07/2013; 6:613-6. DOI:10.2147/IJGM.S49510
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Kawasaki disease (KD) is a generalized systemic vasculitis of unknown etiology involving medium and small size blood vessels, particularly the coronary arteries. In these vessels a progressive stenosis may result from active remodeling with an intimal proliferation and neoangiogenesis. The aim of our study was to assess, by using high-resolution transthoracic 2D Echocardiography, if subjects with a previous diagnosis of Kawasaki disease after several years show a coronary intimal thickening, suggestive of a persistent cardiovascular risk. Methods: We assessed measurement of thickening, inner diameter and outer diameter of coronary arteries using 2D Echocardiography (Philips E 33 with multy-frequency S8-3 and S12-4 probes) and examining the proximal portion of left main coronary artery just above the aortic valve with parasternal short axis view. Results: We found a significant intimal thickening in patients with previous Kawasaki disease compared to healthy controls. In particular, we noticed that also subjects not suffering from coronary impairment in acute phase have higher values of thickening than healthy controls, and this wall thickening may confer a higher cardiovascular risk. Conclusions: Therefore we concluded that the assessment of coronary artery thickening by high-resolution transthoracic 2D Echocardiography may become an essential instrument to evaluate late cardiovascular risk in subjects with a diagnosis of Kawasaki disease in childhood.
    BMC Cardiovascular Disorders 01/2014; 14(106). · 1.88 Impact Factor
Show more