Kawasaki disease in Greek children: a retrospective study

Alexopoulos, A.; Vekiou, Athina; Lycopoulou, Lilia; Tavena, A.; Lagona, Evagelia; Kakourou, Talia

doi:10.1111/j.1468-3083.2012.04488.x

Cited by 11 publications

(13 citation statements)

References 37 publications

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“…[4][5][6][7][8] First described in Japan, KD has now been described worldwide. [9][10][11][12][13][14][15][16][17] However, the disease is markedly more prevalent in children in Japan, where the annual incidence was 243.1 per 100 000 children <5 years of age in 2011 and 264.8 per 100 000 in 2012. The greater susceptibility of children of Japanese ancestry to KD is also evidenced by epidemiological data from Hawaii, where children of Japanese descent had the highest incidence (210.5 per 100 000 children <5 years of age); white children had the lowest incidence (13.7 per 100 000 children <5 years of age).…”

mentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

McCrindle¹,

Rowley²,

Newburger³

et al. 2017

Circulation

2,876

4,124

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BACKGROUND:Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS:To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management. Although the cause remains unknown, discussion sections highlight new insights into the epidemiology, genetics, pathogenesis, pathology, natural history, and longterm outcomes. Prompt diagnosis is essential, and an updated algorithm defines supplemental information to be used to assist the diagnosis when classic clinical criteria are incomplete. Although intravenous immune globulin is the mainstay of initial treatment, the role for additional primary therapy in selected patients is discussed. Approximately 10% to 20% of patients do not respond to initial intravenous immune globulin, and recommendations for additional therapies are provided. Careful initial management of evolving coronary artery abnormalities is essential, necessitating an increased frequency of assessments and escalation of thromboprophylaxis. Risk stratification for long-term management is based primarily on maximal coronary artery luminal dimensions, normalized as Z scores, and is calibrated to both past and current involvement. Patients with aneurysms require life-long and uninterrupted cardiology follow-up. CONCLUSIONS:These recommendations provide updated and best evidence-based guidance to healthcare providers who diagnose and manage Kawasaki disease, but clinical decision making should be individualized to specific patient circumstances. K awasaki disease (KD) is an acute, self-limited febrile illness of unknown cause that predominantly affects children <5 years of age. When initially described, the potential for coronary artery complications was not appreciated. KD is now the most common cause of acquired heart disease in children in developed countries. In the absence of pathognomonic tests, the diagnosis continues to rest on the identification of principal clinical findings and the exclusion of other clinically similar entities with known causes. Timely initiation of treatment with intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery aneurysms defined from absolute luminal dimensions from 25% to ≈4%. Ongoing studies with additional therapies have not substantially reduced this residual risk. The long-term prognosis is determined by the initial and current level of coronary artery involvement. Certain subsets of patients are at risk for myocardial ischemia from coronary artery thrombosis and stenoses. Medical management of such patients hinges on judicious use of thromboprophylaxis and vigilance to identify evolving stenoses. Invasive revascul...

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mentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

McCrindle¹,

Rowley²,

Newburger³

et al. 2017

Circulation

2,876

4,124

View full text Add to dashboard Cite

show abstract

“…[15,16] In other studies performed both in our country and abroad, lymphadenopathy was the least frequently reported diagnostic criterion. [17,18] In the present study, while cervical lymphadenopathy was detected in 61.5% of the patients, it was the least frequently seen symptom. Perrin et al [19] reported a lower incidence rate for peripheral extremity lesions, conjunctivitis, and skin rashes in incomplete Kawasaki disease compared with the complete form of the disease.…”

Section: Discussionmentioning

confidence: 85%

“…[26] In cases of persistent fever following the second dose IVIG, the use of steroids, plasma exchange, infliximab, and cyclophosphamide has been reported. [18] In our study, steroid treatment was called for in 2 cases, and a second dose of IVIG was required for 5 patients. Myocardial infarction or death did not occur.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Children with Kawasaki Disease Hospitalized in Our Clinic: A Retrospective Study

Gündüz¹

2018

South Clin Ist Euras

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Objective: Kawasaki disease is one of the most common childhood forms of vasculitis. The aim of this study was to evaluate children with Kawasaki disease hospitalized in our pediatrics department over a 6-year period.Methods: A total of 39 children treated for Kawasaki disease in the pediatric department between January 2008 and December 2013 were evaluated retrospectively.Results: Of 39 patients, 29 (74.3%) were male and 10 (25.6%) were female. The male/ female ratio was 2.9. The mean patient age was 31.82±20.31 months. In all, 2 patients were diagnosed with Kawasaki disease in

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“…Benzer şekilde bazı çalışmalarda KH'nın mevsimsel dağılım gösterdiği bildirilmektedir. Yunanistan'da bir çalışmada ilkbahar ve yaz aylarında daha sık görüldüğü gözlenmiştir 15 . Bazı çalışmalarda ise olguların sıklıkla kış ve ilkbahar mevsimlerinde görüldüğünden sözedilmektedir 11,16 .…”

Section: Tablo 2 Kawasaki Hastalığının Destekleyici Laboratuvar Tanı Kriterleriunclassified

Kawasaki disease: review of 21 cases

Arat¹,

Acar²,

Türkmenoğlu³

et al. 2016

Cukurova Med J

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Kawasaki disease is common in children and is an acute systemic vasculitis affecting coronary arteries. Kawasaki disease has multisystemic nature with a variety of presenting symptoms. Without treatment 20-25% of Kawasaki disease patients develop coronary artery aneurysms. Our goal is to summarize the clinical data of patients treated with Kawasaki disease at our clinics. Material and Methods: Clinical features, laboratory findings, diagnosis and treatment of 21 patients with Kawasaki disease hospitalized at Turkish Ministry of Health Okmeydanı Training and Research Hospital, Clinic of Pediatrics during January 2009 to January 2015 were retrospectively evaluated.Results: The patients were between 9 and 67 months old (median 27.52± 18.78), 71.4% (n:15) were male. The duration of disease before diagnosis was 7.1±3.48 days, median 6 days. All patients had fever. The most common clinical features were oral cavity changes 95.2% (n:20), rash 85.7% (n:18), conjunctival injection 71.4% (n:15), extremity changes 61,9% (n:13), cervical lymphadenopathy 57.1% (n:12). We also observed sterile pyuria in 33.3%, desquamation of perianal area 28.6 %, aseptic meningitis in 9.5%, hydrops of the gallblader 4.8%. 19.1% patients had incomplete Kawasaki disease. 6 patients, 28.5% had coronary artery abnormalities. Intravenous immunglobulin treatment failure was observed in 9.5% of patients, one of them was diagnosed as macrophage activation syndrome. Conclusion: Kawasaki disease has difficulty in diagnosis because of having broad spectrum of presenting symptoms. Early diagnosis and treatment is very important in preventing coronary artery abnormalities.

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Kawasaki disease in Greek children: a retrospective study

Abstract: Major epidemiologic features of KD detected among Greek children are similar to those reported in other populations. This study also demonstrates that significant cardiac complications may still occur following the disease even if it is diagnosed and treated early.

Cited by 11 publications

References 37 publications

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Clinical Evaluation of Children with Kawasaki Disease Hospitalized in Our Clinic: A Retrospective Study

Kawasaki disease: review of 21 cases

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