Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.
The cases of coronavirusdisease 2019 in children have been increasing with the ongoing pandemic.The finding suggests children have mild symptoms and a short course of the disease. Angiotensinconverting enzyme-2 mediates entry of the virus into the cell, the combination of virus and ACE2 leads to an increase in activity of angiotensin II, resulting in acute injury to lungs, myocardium and other organs. The infection causes down-regulation of ACE2 expression. The ACE2 plays an important role in the infection progression and clinical characteristics of COVID-19. Works on ACE2 and virus spike protein have future prospects of strategic information on prevention, management as well as vaccine development.
Objective: Retrospective clinical analysis of adverse drug reactions in children. Methods: Clinical data analysis was performed on 844 cases of hospitalized children reported for adverse drug reactions. Results: Children under 3 y of age were more prone to the adverse drug reactions; adverse reactions were mainly caused by antibiotics and traditional Chinese medicine; intravenous rout was the most common mode of administration of drug causing adverse reaction; adverse drug reaction was mostly observed within 1 h of drug administration; most common clinical manifestation of adverse drug reactions was the skin damage. Conclusions: More attention should be paid towards rational use of drugs, to avoid multiple drug use as far as possible, and to focus on prevention of adverse drug reactions, timely detection if happened and immediate treatment. Establishment of drug reaction reporting system will definitely help the physicians across the globe to better understand the phenomenon.
Background: Outbreaks of hand-foot-and-mouth disease (HFMD) have occurred in many parts of the world, particularly in China. The disease usually has ease of communicability and a higher risk of developing severe complications leading towards death. In this study, we aim to evaluate the clinical features, laboratory examination, and treatment for serious cases of HFMD, using a retrospective analysis based on clinical data. Methods: We report the clinical features of 22 deceased patients with confirmed diagnoses of HFMD, who presented to hospitals in the Shanxi Province of China between June 2010, and August 2012. Demographic, clinical and laboratory data from inpatients were collected. Results: The findings of this report showed that Enterovirus 71 (EV71) is the causative agent of HFMD, particularly in male children under the age of 3. Some common symptoms including fever, rash, and malfunctioning of respiratory, circulatory, and neurologic systems were observed in all studied patients. However, circulatory failure was the most important cause of death for these patients. Furthermore, increases in the peripheral white blood cell count (>15 × 10 9 /L) and the blood sugar level (>8.3 mmol/L) are among the important reference indices for serious cases. Hence, on time provision of respiratory and circulatory supports enhance the efficiency of a comprehensive treatment strategy. Conclusion: HFMD, characterized by high fever, convulsions, mental fatigue, vomiting and cold limbs, carries a high risk of death. Earlier identification of higher-risk infants might allow for more rapid intervention. Our findings suggest that the peripheral white blood cell count (>15 × 10 9 /L) and the blood sugar level (>8.3 mmol/L) should be considered as warning signs while, clinicians manage surges of children diagnosed with HFMD to avoid death.
Kawasaki disease (KD) is an acute, febrile, erupting, self-limited autoimmune disease with systemic vasculitis as the main lesion. It is more common in children under 5 years old, and the main lesions associate the coronary arteries. With the increasing incidence, it has become the first cause of acquired heart disease in children. There are many basic and clinical studies on Kawasaki disease at home and abroad, but there are few animal experimental studies on the treatment of coronary artery injury with stem cells. Therefore, it is of great value to select scientific experimental animal models for Kawasaki disease research to simulate the human characteristics of Kawasaki disease. Through the establishment and in-depth study of animal models of Kawasaki disease, it is helpful to better understand the pathophysiology, cytokines and molecular pathways related to disease advancement of Kawasaki disease. At the same time, it will augment the way for the development of new and effective diagnosis and treatment of Kawasaki disease. Therefore, based on the study of coronary artery lesion animal model of Kawasaki disease with stem cells, this article mainly discusses the research and new progress of Kawasaki disease animal models, so as to provide a good theoretical basis for clinical and animal experimental research. And make a review on this issue.
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