Arthritis in Kawasaki disease after responding to intravenous immunoglobulin treatment

Lee, Kyung-Yil; Oh, Jin-Hee; Han, Ji-Whan; Lee, Joon Sung; Lee, Byung-Churl

doi:10.1007/s00431-005-1653-8

Cited by 28 publications

(33 citation statements)

References 5 publications

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“…The frequency of late-onset arthritis may be less common since the introduction of IVIG therapy and was as low as 2% in a recent report. 5 The joint manifestations observed in KD are most consistent with either a virus-induced or reactive arthritis. Epidemiologic and immunologic studies of KD suggest an infectious trigger, but the cause of KD remains elusive.…”

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confidence: 95%

Cervical Spine and Temporomandibular Joint Arthritis in a Child With Kawasaki Disease

et al. 2006

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Severe neck pain, stiffness, and torticollis in a child with Kawasaki disease commonly represent aseptic meningitis or lymphadenitis. Here we present an unusual case of severe cervical spine and bilateral temporomandibular joint arthritis in a 5-year-old boy with a relapse of Kawasaki disease and coronary artery ectasia. The patient had a favorable response to a second course of intravenous immunoglobulin G and indomethacin therapy, with complete resolution of his symptoms.

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confidence: 95%

Cervical Spine and Temporomandibular Joint Arthritis in a Child With Kawasaki Disease

et al. 2006

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“…Arthritis in KD has long been described and was reported in 31% of patients in the pre‐intravenous immunoglobulin (IVIG) era . The prevalence decreased to 2–7.5% due to the anti‐inflammatory effect of IVIG . Although joint involvement has not been specifically associated with a worst outcome, a body of literature has demonstrated that this subgroup of patients has a more pronounced systemic inflammation and IVIG resistance .…”

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confidence: 99%

“…It is not a major diagnostic criterion in KD. It is possible that the presence of arthritis in KD is missed as joints cannot be easily assessed in a febrile irritable child …”

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confidence: 99%

Arthritis in Kawasaki disease: A poorly recognised manifestation

Martins

Conde

Brito

et al. 2018

J Paediatrics Child Health

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“…Arthritis has previously been reported in Kawasaki disease in 7.5-45% of cases, in both acute or subacute phases, [7][8][9] and although determined to be a transient finding, 1,7 it has also been reported after immunoglobulin therapy. 10,11 It was hypothesized that arthritis would be associated with a higher degree of inflammation and thus immunoglobulin resistance.…”

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confidence: 99%

Immunoglobulin Resistance in Kawasaki Disease

Hartas

Hashmi

Pham-Peyton

et al. 2015

Pediatric Allergy, Immunology, and Pulmonology

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Background: The aim of this study was to identify risk factors for immunoglobulin resistance, including clinical symptoms such as arthritis and the pH of intravenous immunoglobulin. Methods: The data of children with Kawasaki disease who had received immunoglobulin were evaluated. Data regarding the brand of immunoglobulin administered were abstracted from the pharmacy records. Results: Eighty consecutive children with Kawasaki disease were evaluated (Mdn age = 28 months, 66% male). The prevalence of immunoglobulin resistance was 30%. Arthritis was a presenting symptom in the acute phase of Kawasaki disease in 8% (6/80, all male) and was seen in significant association with immunoglobulin resistance in comparison to those without arthritis (16.7% vs. 0.2%, p = 0.008). Next, the immunoglobulin brand types were divided into two groups: the relatively high pH group (n = 16), including Carimune (pH 6.6 -0.2), and the low pH group (n = 63), including Gamunex (pH 4-4.5) or Privigen (pH 4.6-5). Overall, no significant difference in immunoglobulin responsiveness was found between the low pH and the high pH groups (73% vs. 56%, p = 0.193), although the low pH group showed a trend toward a larger decrease in erythrocyte sedimentation rate ( p = 0.048), lower steroid use ( p = 0.054), and lower coronary involvement ( p = 0.08) than those in the high pH group. Conclusions: Children presenting with arthritis in the acute phase of Kawasaki disease may be at risk for immunoglobulin resistance.

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Arthritis in Kawasaki disease after responding to intravenous immunoglobulin treatment

Cited by 28 publications

References 5 publications

Cervical Spine and Temporomandibular Joint Arthritis in a Child With Kawasaki Disease

Cervical Spine and Temporomandibular Joint Arthritis in a Child With Kawasaki Disease

Arthritis in Kawasaki disease: A poorly recognised manifestation

Immunoglobulin Resistance in Kawasaki Disease

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