Two infants with tuberculid associated with Kawasaki disease

Yamada, Hiroko; Ohta, H.; Hasegawa, Shunji; Azuma, Yoshihiro; Hasegawa, Motoharu; Kadoya, Ryo; Ohbuchi, Noriko; Ohnishi, Yuji; Okada, Seigo; Hoshide, Madoka; Ohga, Shouichi

doi:10.1080/21645515.2016.1208329

Cited by 11 publications

(9 citation statements)

References 24 publications

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“…The lesions seen in our patient s cheeks were clinically compatible with papulonecrotic tuberculid but biopsy was not performed. Tuberculids and the BCG reaction could be linked to the immune activation to an unknown microorganism as suggested by Yamada et al 1 Another interesting clinical observation is that erythema in both BCG and PPD inoculation sites have been described in K D , reinforcing the notion that this is a non specific inflammatory reaction. 14 Importantly, it has been suggested that the tuberculin skin test (PPD) could provide a diagnostic tool to identify incomplete forms of KD in non-vaccinated patients.…”

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confidence: 77%

“…We read with great interest the article by Yamada et al reporting 2 Japanese infants with tuberculid associated with Kawasaki disease (K D ). 1 Reactivation in BCG site is present in about 30-50% of K D patients. [2][3][4][5] The local inflammatory reactivation of the BCG vaccination site was first highlighted in the Japanese literature as a specific early sign of K D , although it has been recognized for decades, its pathophysiology continues to be an enigma.…”

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confidence: 99%

“…Tuberculids arise from an immunological reaction triggered by a Mycobacterium tuberculosis infection elsewhere in the body. 1 There are 3 main clinical manifestations of cutaneous tuberculid: lichen scrofulosorum, papulonecrotic tuberculid and erythema induratum of Bazin. There is evidence that it could be an immunological reaction in the skin to haematogenous spread of bacilli or fragments of bacilli.…”

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confidence: 99%

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BCG and Kawasaki disease in Mexico and Japan

Gámez-González

Hamada

Llamas-Guillen

et al. 2017

Human Vaccines & Immunotherapeutics

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Dr. Tomisaku Kawasaki was the first to describe BCG reactivation in Kawasaki Disease (K), and this sign is present in about 30-50% of K patients. It is a very specific early sign of the disease and although it has been recognized for decades, its pathophysiology continues to be an enigma. Recently, Yamada et al. reported a severe BCG reaction with tuberculid in 2 Japanese K patients. We present 2 cases with K and severe BCG reaction, one from Japan and the other from Mexico and review the policies of administration of BCG in both countries. The BCG vaccine has a worldwide coverage of 88%. Differences in BCG strains and methods of administration may influence BCG reactions in K. The BCG reaction in the inoculation site may represent the most useful sign in K.

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confidence: 77%

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confidence: 99%

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confidence: 99%

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BCG and Kawasaki disease in Mexico and Japan

Gámez-González

Hamada

Llamas-Guillen

et al. 2017

Human Vaccines & Immunotherapeutics

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“…Some studies have confirmed that the epidemiology of KD and the higher incidence of CAD are both related to infection (23)(24)(25). Superantigens produced by bacteria (26,27), viruses (28)(29)(30), atypical pathogens (31), and fungi (32) may trigger immune disorder and cause KD. In the 2019 coronavirus disease (COVID-19) pandemic, a large number of children with KD-like symptoms appeared in the United Kingdom, the United States, and Italy.…”

Section: Ifn-β and Kdmentioning

confidence: 99%

Combined IFN-β and PLT Detection Can Identify Kawasaki Disease Efficiently

et al. 2021

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Objective: To evaluate the value of combined interferon β (IFN-β) and platelet (PLT) detection for Kawasaki disease (KD) identification.Methods: Forty-four children who were newly diagnosed with KD were selected as the KD group. They were divided into acute phase of KD and subacute phase of KD. They were also separated into groups with and without coronary artery disease (CAD) (CAD+ and CAD–, respectively). Meanwhile, 44 children hospitalized with febrile disease and 44 healthy children were selected as a febrile control group and normal control group, whom were attended to at Children's Hospital of Soochow University at the same time. We detected the concentration of IFN-β and PLT of peripheral blood serum for all three groups and analyzed the difference.Results: At acute and subacute phases of KD, both IFN-β and PLT are higher than both the febrile control group and healthy control group, especially at subacute phase; the difference between groups was statistically significant, P < 0.05. Receiver operating characteristic (ROC) curve showed that the areas under the ROC curve (AUCs) of IFN-β and PLT at acute phase of KD were 0.81 and 0.72, respectively; the sensitivity and specificity were 97.22 and 63.64%, and 57.89 and 73.86%, respectively. The AUCs of combined IFN-β and PLT were 0.81 at acute phase and 0.96 at subacute phase of KD, with sensitivity and specificity of 97.22 and 55.26%, and 86.36 and 100%, respectively. The cutoff value of combined IFN-β and PLT detection was IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD, IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase from plot vs. criterion values. However, there are no significant differences between the CAD– group and the CAD+ group for combined IFN-β and PLT, both P > 0.5, neither at acute nor at subacute phase of KD.Conclusion: Combined IFN-β and PLT detection is an efficient biomarker for KD identification. The cutoff values are IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD and IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase.

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“…A betegség etiológiája a mai napig sem tisztázott, az elmúlt 50 évben különböző elméleteket állítottak fel a szindróma eredetére (11)(12)(13)(14)(15)(16)(17)(18). Felmerült a betegség infekciózus eredete is, ahol vizsgál-ták többek között a Mycobacterium tuberculosis (19), Mycoplasma pneumoniae (20) Kawasaki Kontroll…”

Section: Megbeszélésunclassified