Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

Lee, Wendy; Cheah, Chooi San; Suhaini, Siti Aisyah; Azidin, Abdullah Harith; Khoo, Mohammad Shukri; Ismail, Noor Akmal Shareela; Ali, Adli

doi:10.3390/medicina58060734

Cited by 13 publications

(15 citation statements)

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“…In our study, 43.5% of the patients had gastrointestinal symptoms, namely vomiting and diarrhea This was higher (61,62). We also found that there was a significant difference of platelet count between complete KD and incomplete KD patients.…”

Section: Discussionsupporting

confidence: 57%

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

et al. 2023

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IntroductionKawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the epidemiology, clinical features, treatment, and outcomes of KD among the pediatric patients admitted to Hospital Canselor Tunku Muhriz (HCTM), Kuala Lumpur, Malaysia.MethodA retrospective cohort study of 66,500 pediatric patients presented at HCTM from the year 2004 to 2021 was conducted.Results62 KD cases out of 66,500 pediatric admissions were reported, with a male-to-female ratio of 1.58 to 1. Majority of KD patients (95.0%) were younger than 5 years old. Prior infection was reported in 5 KD patients (8.1%). Apart from the classical features, manifestations of various organ systems including cardiovascular (16.1%), gastrointestinal (43.5%), neurological (1.61%), musculoskeletal (1.61%), and genitourinary (17.7%) systems were observed. There was a significant association between sterile pyuria and coronary artery aneurysm (CAA) (p < 0.05). Interestingly, abnormal liver parameters (p < 0.05) and incomplete KD (p < 0.05) were significantly related to IVIG resistance.DiscussionThe presence of family history, immunological disorder, and previous infection in our KD patients suggested that there is a possibility of genetic, immunological, and infectious roles in the pathophysiology of KD. IVIG resistance is more likely to occur in KD patients with hepatic dysfunction or incomplete KD presentation. These findings highlighted the significant contribution of laboratory parameters to the prognosis of KD, prompting more in-depth research on the KD scoring systems and their relevance in this country.

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Section: Discussionsupporting

confidence: 57%

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

et al. 2023

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“…Though the trend increases every year, to date, the main aetiology of KD has remained mystery since its first discovery in 1967. Various factors have been suggested as potential causes, including infectious agents such as viruses and bacteria, ethnicity, genetics, and exposure to cigarette smoke [ 1 ]. Evidence suggests that infection, particularly in genetically susceptible individuals, plays a significant role in the development of KD [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…IVIG is the first-line treatment for KD [ 32 , 33 ]. However, clinicians are recommended to consider adjunctive treatment [ 34 , 35 , 36 ] like corticosteroids, infliximab, etanercept, plasmapheresis, and secondary IVIG infusion [ 1 ], especially in cases in which there is an increased risk of developing CAA. Further research is needed to clarify the role of adjuvant therapy in patients with concomitant KD and rotavirus infection.…”

Section: Discussionmentioning

confidence: 99%

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Concomitant Kawasaki Disease and Rotavirus Infection—More Than Just a Coincidence: A Case Report

Khoo,

Ali

2023

TropicalMed

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The definitive role of viral infections, such as rotavirus, in causing Kawasaki disease (KD) remains uncertain. However, the intriguing observation of concomitant rotavirus infection and KD suggests a potential association. This study aimed to investigate this relationship. We reported a case of concomitant KD and rotavirus infection complicated by hyponatraemia and anasarca. For the systematic review, we used three large databases, namely PubMed, Ovid, and Scopus, to search articles with the terms “Kawasaki” and “rotavirus”. We also used Google Scholar as our secondary source. We included articles that fulfilled the following criteria: (i) articles reporting on children aged 18 and below; (ii) articles reporting on patients infected with rotavirus prior to or concomitant with KD; and (iii) articles written in English only. Three articles were included and analysed in combination with our reported patient. All patients exhibited gastrointestinal symptoms, including diarrhoea and vomiting, in addition to non-resolving fevers, which eventually manifested more signs and symptoms to support the diagnosis of KD. Stool samples from all patients revealed positive rotavirus antigens. Two patients (n = 2) were noted to have hyponatraemia and hypoalbuminaemia. Three (n = 3) manifested coronary artery abnormalities (CAA). Even though the relationship is not fully understood yet, it is known that the combination of these two pathologies can cause catastrophic immune responses and complications.

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“…The etiology of KD is unknown, but it is believed that an infectious agent and a genetic predisposition are involved ( 4 ). Measles, non-exudative pharyngitis, retropharyngeal abscess, bacterial cervical adenitis and scarlet fever are misdiagnosed with KD due to their similar manifestations ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiological data of national Kawasaki disease registry in Iran, 2007–2019

Shahbaznejad

Hosseininasab²,

Mahboobi³

et al. 2023

Front. Pediatr.

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IntroductionKawasaki disease(KD) is a vasculitis of childhood that tends to influence the coronary arteries. There is no national data about the prevalence of KD in Iran. This study aimed to perform a national registry in Iran for 13 years.MethodsIn this retrospective study, the data for KD extracted from medical records of <19 year-old patients admitted to tertiary hospitals in Iran between 2007 and 2019 were recorded in the national KD registry system. Age, admission date, gender, location, and presence of KD criteria, laboratory and echocardiography findings, and treatment modalities were evaluated. Complete KD was considered if ≥4 clinical criteria of the KD existed and otherwise, incomplete KD was considered.ResultsData from 1,682 KD patients including 999(59.39%) boys and 683(40.61%) girls and male/female ratio of 1.46 were evaluated. The mean age was 3.08 ± 2.49 years and 1465(87%) were living in urban regions. The yearly incidence of the disease was between 2.62 to 3.03 from 2015 to 2019. The highest age-specific incidence was observed in children <1-year-old. Incomplete and resistant KD included 1,321(78.54%) and 9(0.54%) patients, respectively. Abnormal echocardiography was detected in 619(36.80%) patients. Leukocytosis, with dominancy of neutrophils, anemia, thrombocytosis and increased ESR and CRP were the most noticeable laboratory findings. No death due to KD disease was reported.ConclusionBased on this study, most of the KD cases are presented with atypical presentation in Iran. So, increasing awareness of primary healthcare workers by educating and updating their data is very important in timely diagnosis and management of the disease.

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Clinical Manifestations and Laboratory Findings of Kawasaki Disease: Beyond the Classic Diagnostic Features

Cited by 13 publications

References 124 publications

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

Concomitant Kawasaki Disease and Rotavirus Infection—More Than Just a Coincidence: A Case Report

Epidemiological data of national Kawasaki disease registry in Iran, 2007–2019

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