Kawasaki disease: Clinico-laboratory spectrum and outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan

Sakina, Seema; Owais, Syeda Sobya; Khan, Ejaz Ahmed; Sheikh, Abdul Malik

doi:10.12669/pjms.36.2.910

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…Although there is actually no scientific proof confirming this association (between KD and COVID-19), doctors should take it into consideration. This is because the KD may alter the quality of life of children and is the most common cause leading to paediatric heart disease [29]. Echocardiogram is necessary at the baseline and at the six week.…”

Section: Why Doctors Should Be More Careful When Dealing With Childrementioning

confidence: 99%

“…This disease often occurs in children aged less than 5 years old but an early treatment by intravenous immunoglobulin can reduce the mortality and morbidity [29]. The diagnostic of the KD requires the presence of persistent fever at least five days, in combination with four of five features belonging to this following list: conjunctivitis, lymphadenopathy,rash, erythema and hyperaemia of lip and oral mucosa and finally hyperaemia and desquamation in extremities [29]. Doctors should be vigilant and evoke KD in children with fever, rash and severe inflammation in patients with or without confirmed COVID-19 but should also screen for SARS-CoV-2 in patients with KD.…”

Section: Why Doctors Should Be More Careful When Dealing With Childrementioning

confidence: 99%

See 1 more Smart Citation

Paediatric aspects of COVID-19: An update

Kammoun

Masmoudi

2020

Respiratory Medicine and Research

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Section: Why Doctors Should Be More Careful When Dealing With Childrementioning

confidence: 99%

Section: Why Doctors Should Be More Careful When Dealing With Childrementioning

confidence: 99%

Paediatric aspects of COVID-19: An update

Kammoun

Masmoudi

2020

Respiratory Medicine and Research

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“…However, Pakistan lies in a region where the estimated incidence of KD is about 70 per 100,000 children, which is a significant statistic, and it underlines the importance of having an effective diagnostic tool [ 9 ]. Furthermore, local studies have reported a high incidence of coronary artery involvement in children with KD (about 41% in Karachi and 32% in Islamabad) [ 10 , 11 ]. Therefore, early identification of these children becomes essential; hence, our study aimed to evaluate serum NT-proBNP, H 2 S, and IL-6 levels in children suffering from KD and determine their association with the development of CAL in the pediatric population visiting a tertiary care hospital in Karachi.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Serum N-Terminal Pro-Brain Natriuretic Peptide and Endogenous Hydrogen Sulfide for Predicting Coronary Artery Lesions in Pediatric Kawasaki Disease Patients: Findings From a Tertiary Care Hospital in Karachi, Pakistan

Bilal¹,

Haseeb²,

Saeed³

et al. 2020

Cureus

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Introduction Kawasaki disease (KD) is an idiopathic, acute systemic vasculitis typically affecting medium-sized blood vessels with an inclination towards the coronary arteries. There is no specific diagnostic test established for it yet. Hence, our study aims to evaluate serum N-terminal pro-brain natriuretic peptide (NT-proBNP), hydrogen sulfide (H 2 S), and interleukin-6 (IL-6) levels as potential diagnostic tools in children with KD and determine its relationship with the development of coronary artery lesions (CAL) in the pediatric population visiting a tertiary care hospital in Karachi. Methods A prospective observational study was performed on a sample of 500 children at a tertiary care hospital over a period of two years from June 2017 to June 2019. Blood samples were collected from two groups labeled CAL and non-coronary artery lesion (NCAL), and different biomarkers including NT-proBNP, IL-6, and H 2 S were compared between them to predict the diagnostic properties of each marker. Results Among the 500 children, 50% were between the age of one to five years. All presented with fever and varying degrees of associated symptoms. On lab investigations, levels of NT-proBNP and IL-6 during the acute phase of the disease were found to be higher in the CAL group than the NCAL and control groups (p<0.001). However, H 2 S levels during the acute attack were significantly lower in the CAL group when compared to the NCAL or control groups (p<0.001). Conclusion Elevated levels of NT-proBNP and IL-6 can be utilized as potential clinical markers for identifying children at risk of developing CAL as a complication of KD. Reduced H 2 S levels are also proposed as an indicator of progress towards CAL and should be considered in reaching a diagnosis.

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“…At the same time, aspirin was taken orally at a dose of 40 mg/kg three times a day, which gradually decreased to 3-5 mg/kg·d after the fever subsided for three days, and maintained for 6-8 weeks or until the indicators such as blood routine and erythrocyte sedimentation rate returned to normal. 7 The experimental group was given HDIVIG combined with low-dose prednisone acetate on the basis of the above treatment. The specific treatment regimen was as follows: immunoglobulin 2g/kg, intravenous drip, single dose application.…”

Section: Methodsmentioning

confidence: 99%

Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease

Zhang¹,

Wang²,

Teng³

et al. 2021

Pak J Med Sci

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Objective: To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD). Methods: Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated. Results: After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04). Conclusion: HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced. doi: https://doi.org/10.12669/pjms.37.4.4023 How to cite this:Zhang H, Wang MY, Teng YN, Wang XD, Cao HT. Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4023 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Kawasaki disease: Clinico-laboratory spectrum and outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan

Cited by 6 publications

References 18 publications

Paediatric aspects of COVID-19: An update

Paediatric aspects of COVID-19: An update

The Importance of Serum N-Terminal Pro-Brain Natriuretic Peptide and Endogenous Hydrogen Sulfide for Predicting Coronary Artery Lesions in Pediatric Kawasaki Disease Patients: Findings From a Tertiary Care Hospital in Karachi, Pakistan

Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease

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