Clinical and epidemiologic characteristics of patients referred for evaluation of possible Kawasaki disease

Burns, Jane C.; Mason, Wilbert H.; Glodé, Mary P.; Shulman, Stanford T.; Melish, Marian E.; Meissner, Cody; Bastian, John F.; Beiser, Alexa; Meyerson, Harvey M.; Newburger, Jane W.

doi:10.1016/s0022-3476(05)80026-5

Cited by 176 publications

(88 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[75][76][77][78] Mild to moderate elevations in serum transaminases occur in Յ40% of patients and mild hyperbilirubinemia in ϳ10%. 79 Plasma gammaglutamyl transpeptidase is elevated in ϳ67% of patients. 80 Hypoalbuminemia is common and is associated with more severe and more prolonged acute disease.…”

Section: Laboratory Findingsmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

Self Cite

1,692

2,533

View full text Add to dashboard Cite

ABSTRACT. Background. Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ϳ15% to 25% of untreated children and may lead to ischemic heart disease or sudden death.Methods and Results. A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for >5 days and <4 classic criteria should undergo electrocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-␣ antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata.Conclusions. Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients. Pediatrics

show abstract

Section: Laboratory Findingsmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Pediatrics

Self Cite

1,692

2,533

View full text Add to dashboard Cite

show abstract

“…[75][76][77][78] Mild to moderate elevations in serum transaminases occur in Յ40% of patients and mild hyperbilirubinemia in Ϸ10%. 79 Plasma gammaglutamyl transpeptidase is elevated in Ϸ67% of patients. 80 Hypoalbuminemia is common and is associated with more severe and more prolonged acute disease.…”

Section: Laboratory Findingsmentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Newburger¹,

Takahashi²,

Gerber³

et al. 2004

Circulation

Self Cite

1,600

818

View full text Add to dashboard Cite

Background— Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ∼15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results— A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-α antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions— Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.

show abstract

“…KH, jüvenil romatoid artrit gibi romatolojik hastalıklar ve kızamık, adenovirüs ve Grup A streptokokal enfeksiyonlar gibi enfeksiyonlarla karışabilmektedir (5)(6)(7) . Sıklıkla 6 ay -5 yaş arasında görülse de her yaşta KH görülebilmek-tedir.…”

Section: Introductionunclassified

Kawasaki disease: An evaluation of children in Erzurum

Kara¹,

Güllü²,

Balaban³

2017

BUCH

View full text Add to dashboard Cite

ÖZAmaç: Kawasaki hastalığı (KH) çocukluk çağında edinilmiş kalp hastalıklarının en sık nedenlerindendir. Ülkemizdeki insidansı bilinmeyen hastalık multisistemik vaskülitik bir sendrom olup, pek çok organı ve sistemi etkilemektedir. Yöntem: Erzurum Bölge Eğitim ve Araştırma Hastanesinde KH tanısı konulan hastaların klinik ve laboratuvar bulguları retrospektif olarak incelendi. Bulgular: Hastaların yaş ortalaması 4,1±2,4 yıldı, 8'i (%66,6) erkek, 4'ü (%33,3) kızdı. Hastaların başvuruda ortalamaları 8,5±3,5 gündü, semptomları mevcuttu. On (%83,3) hastaya akut, 2 (%16,6) hastaya subakut KH (12 ve 17 gün) tanısı konuldu. Hastaneye en sık başvuru üçer olguyla 4. ve 9. aylarda oldu. Tüm hastaların en az 5 günden beri süren ateşi ve oral mukoza değişiklikleri mevcuttu. Diğer sık bulgular, on birer (%91,7) hastada konjunktivit ve polimorfik ekzantemdi. On (%83,3) hastanın komplet, 2 (%16,6) hastanın inkomplet KH vardı. İkişer (%16,6) hastada safra kesesi hidropsu ve BCG aşısı reaktivasyonu saptandı. Çalışmada, beyaz küre sayısı, C-reaktif protein ve eritrosit sedimentasyon hızı ortalama değerleri normal sınırların üzerindeydi. Trombositoz 4 (%33,3), hiponatremi 8 (%66,6), hipoalbüminemi 3 (%25) ve steril piyüri 3 (%25) hastada gözlendi. Dört (%33,3) hastada ekokardiyografide bulgu (2'sinde sol koroner arterde dilatasyon, 2'sindeyse intravenöz immünglobulin [IVIG] tedavisiyle gerilemiş olan hafif mitral yetmezlik ve sol ventrikül fonksiyonlarında azalma) saptandı. Tüm hastalara tanı anında IVIG, hastaların 9'una yüksek doz, 3'üne düşük doz asetil salisilat başlandı. Bir (%8,3) hastaya ikinci doz IVIG verildi. Koroner dilatasyonu bulgularının 3. ve 6. aydaki kontrollerde gerilese de devam ettiği görülerek asetil salisilat tedavilerine devam edildi. Sonuç: Nadir görülen ancak yüksek morbidite riskine sahip KH ülkemizde Doğu Anadolu bölgesinde de görülmektedir. Hızlı tedaviyle komplikasyonlar önlenebileceği için hastalığın hakkında farkındalığın artması önemlidir. Anahtar kelimeler: Asetil salisilat, intravenöz immünglobulin, Kawasaki hastalığı ABSTRACTObjective: Kawasaki disease (KD) is a frequently seen acquired childhood heart disease. This multisystemic vasculitic syndrome involves most organs and systems. The incidence in Turkey is unknown. Methods: Patients with KD at the Erzurum Regional Training and Research Hospital were retrospectively evaluated. Results: Patients' mean age was 4.1±2.4 years; eight (66.6%) patients were male and four (33.3%) female. Symptoms persisted for a mean 8.5±3.5 days. Ten (83.3%) patients were diagnosed with acute KD and two (16.6%) with subacute KD. Admission was most common in the 4 th and 9 th months with three cases each. All patients had fever for at least five days and oral mucosa changes. Other findings were conjunctivitis and polymorphic exanthems in 11 (91.7%) patients. Ten (83.3%) patients had complete KD and two 2 (16.6%) incomplete KD. Two (16.6%) patients had gallbladder hydrops and two (16.6%) had BCG vaccine reactivation. White blood cell count, CRP, and ESR were above norma...

show abstract

Clinical and epidemiologic characteristics of patients referred for evaluation of possible Kawasaki disease

Cited by 176 publications

References 6 publications

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease

Kawasaki disease: An evaluation of children in Erzurum

Contact Info

Product

Resources

About