High incidence of aortic regurgitation following Kawasaki disease

Nakano, Hiroyuki; Nojima, Keiko; Saito, Akihiro; Ueda, Ken

doi:10.1016/s0022-3476(85)80615-6

Cited by 49 publications

(24 citation statements)

References 15 publications

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“…Aortic regurgitation has been documented angio- graphically by Nakano and colleagues 139 in ϳ5% of children with Kawasaki disease and was attributed to valvulitis. Other investigators have observed a much lower incidence of aortic regurgitation in the acute phase, 2 but late-onset aortic regurgitation has been reported as an exceedingly rare finding after Kawasaki disease and may be associated with the need for aortic valve replacement.…”

Section: Valvular Regurgitationmentioning

confidence: 96%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

1,697

2,533

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ABSTRACT. Background. Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ϳ15% to 25% of untreated children and may lead to ischemic heart disease or sudden death.Methods and Results. A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for >5 days and <4 classic criteria should undergo electrocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-␣ antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata.Conclusions. Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients. Pediatrics

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Section: Valvular Regurgitationmentioning

confidence: 96%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

1,697

2,533

View full text Add to dashboard Cite

show abstract

“…Aortic regurgitation has been documented angiographically by Nakano and colleagues 139 in Ϸ5% of children with Kawasaki disease and was attributed to valvulitis. Other investigators have observed a much lower incidence of aortic regurgitation in the acute phase, 2 but late-onset aortic regurgitation has been reported as an exceedingly rare finding after Kawasaki disease and may be associated with the need for aortic valve replacement.…”

Section: Valvular Regurgitationmentioning

confidence: 95%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Circulation

1,613

818

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Background— Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ∼15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results— A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-α antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions— Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.

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“…Less common features ( Table 2) that have been reported include arthritis [9], aseptic meningitis [9,11], deranged liver enzyme levels [12], and aortic and/or mitral insufficiency [13,14].…”

Section: Discussionmentioning

confidence: 99%

Kawasaki Disease in Kuwait: A Prospective Study of 41 Cases

et al. 1990

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Forty-one children with Kawasaki disease were seen over a 12-year period in two regional hospitals in Kuwait. The average annual incidence during the first 8 years of the study was 0.71 per 100,000 children under the age of 10 years and this increased to 3.44 during the last 4 years. The disease occurred throughout the year, with an increased incidence in winter and spring. The male/female ratio was 2.2/1, and 83% of the children were under the age of 5 years. Fever, rash, and oropharyngeal and extremity changes were encountered in all patients, whereas conjunctivitis and cervical adenitis were detected in 85% and 54%, respectively. The mitral valve was affected in two patients and the aortic valve in one. Of the 19 patients evaluated by echocardiographic studies, three (16%) showed evidence of coronary vasculitis. There was no mortality. The basic clinical and epidemiological features of Kawasaki disease in this area corroborate previously well-recognized findings.

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High incidence of aortic regurgitation following Kawasaki disease

Cited by 49 publications

References 15 publications

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Kawasaki Disease in Kuwait: A Prospective Study of 41 Cases

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