Arthritis presenting during the acute phase of Kawasaki disease

Severe Skin Lesions or Arthritis May be Associated with Coronary Artery Lesions in Kawasaki Disease

“…Arthritis usually appears in the acute stage, but it can be observed after IVIG treatment 19) . In articular types in KD, pauciarticular type was predominant to polyarticular type as well as in this study 1,20) .…”

“…The incidence of arthritis may be dramatically reduced in IVIG era as well as that of severe CALs (aneu rysms) 1) . Arthritis usually appears in the acute stage, but it can be observed after IVIG treatment 19) .…”

“…The major complication of KD, i.e., coronary artery lesions (CALs), became the most common cause of acquired heart disease in developed countries 1,2) . CALs occurred in www.piv.or.kr 15-25% of children with KD in the era of no intravenous immunoglobulin (IVIG) treatment, but occurred in 5% of children treated with standard IVIG treatment 3,4) .…”

Immunoglobulin Resistance in Kawasaki Disease

“…A prevalence rate of arthritis of 6.3% was found in the acute phase of Kawasaki disease in patients in the current study, similar to a previously published report where it was 7.5%. 7 In patients in the present study, arthritis was seen in the acute phase of Kawasaki disease prior to any immunoglobulin therapy, all in male gender, usually involving large joints, and was both oligoarticular and polyarticular (one child also had cervical arthritis). This may be explained by the fact that a higher degree of ''leaky'' vessels 45 would lead to more joint effusions and edema in children with immunoglobulin-resistant Kawasaki disease.…”

“…3,4 However, there is still much to know about this group of resistant patients, and they warrant further investigation in order to determine factors that contribute to their resistance. Arthritis has previously been reported in Kawasaki disease in 7.5-45% of cases, in both acute or subacute phases, [7][8][9] and although determined to be a transient finding, 1,7 it has also been reported after immunoglobulin therapy. 10,11 It was hypothesized that arthritis would be associated with a higher degree of inflammation and thus immunoglobulin resistance.…”