Epidemiology, Etiology, and Management of Kawasaki Disease: State of the Art

Laupland, Kevin B.; Davies, H. Dele

doi:10.1007/s002469900436

Cited by 62 publications

(37 citation statements)

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“…K awasaki disease (KD) is an acute febrile illness of unknown cause. [1][2][3] It is known to affect young children causing persistent high fever and signs of systemic inflammation. KD is associated with development of coronary aneurysm and myocarditis and is the leading cause of acquired heart disease among children in the United States and many developed nations.…”

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confidence: 99%

Hospitalizations for Kawasaki Disease Among Children in the United States, 1988–1997

Chang

2002

Pediatrics

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ABSTRACT. Objective. To evaluate the epidemiologic pattern of Kawasaki disease (KD) in the United States over 10 years.Methods. The National Inpatient Sample, a stratified national sample of >900 hospitals in 22 states of the United States, was used. Data on hospital discharges from 1988 -1997 were analyzed. Patients <18 years of age with a discharge diagnosis of KD were identified.Results. There were 6442 patients with KD admitted to 651 hospitals. Median age at hospital admission was 2 years. Peak incidence by year of age was 1 year old. Children <2 years old accounted for 36.6% of all cases; <5 years old, 75.6%; and <10 years old, 95.6%. The age distribution seems to be wider than reported from Japan. The incidence for children <5 years old was 8.1 per 100 000 people in 1988, and increased to 18.5 in 1997. There were 3905 males (60.6%) and 2537 females (39.4%), for a male-to-female ratio of 1.54. The incidences were higher in winter and spring (December to May) and dropped to a nadir between July and September. No apparent change in seasonal pattern was noted over 10 years. The South census region showed a seasonal change 2 to 3 months ahead of other regions. The overall in-hospital mortality rate was 0.17%. The mortality rate in children >10 years (1.4%) was significantly higher in than children <10 years (0.11%).Conclusions. KD affects mainly children under 5 years of age, with a peak incidence in children 1 to 2 years of age. The incidence of KD was rising over the study period. There is a male predominance. Although KD occurs year-round, the lowest incidence is seen from July through September. Such seasonal variation did not change over the 10 years. Seasonal pattern may vary in different geographic regions. Mortality from KD is rare, although children >10 years are at higher risk. Pediatrics 2002;109(6). URL: http://www.pediatrics.org/cgi/content/ full/109/6/e87; Kawasaki disease, epidemiology, United States.ABBREVIATIONS. KD, Kawasaki disease; NIS, Nationwide Inpatient Sample; IVIG, intravenous immunoglobulin; AHA, American Heart Association. K awasaki disease (KD) is an acute febrile illness of unknown cause. [1][2][3] It is known to affect young children causing persistent high fever and signs of systemic inflammation. KD is associated with development of coronary aneurysm and myocarditis and is the leading cause of acquired heart disease among children in the United States and many developed nations. Although KD is much more common in Japan, cases of KD have been reported worldwide. Epidemiologic studies have shown that KD affects mainly children under 5 years of age with a male predominance. Most epidemiologic information on KD has come from Japan where a nationwide epidemiologic survey is conducted every 2 years. 4 -7 There has been limited, up-to-date epidemiologic information on KD in the United States. 8 -12 Recent reports indicate that most (Ͼ96%) children with KD are hospitalized. 13,14 Therefore, data from hospital discharges provide valuable sources for investigating the epidemiology of ...

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Hospitalizations for Kawasaki Disease Among Children in the United States, 1988–1997

Chang

2002

Pediatrics

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“…Epidemiological studies have indicated that infection is a possible etiology for KD, and immune-associated loci have also been a focus of candidategene research for KD susceptibility determinants (39,40). The high prevalence of KD in Asian (especially Japanese) strongly implies a genetic predisposition to developing KD, given that Japanese children with Western lifestyle still have the similar increased risk of developing the disease (41)(42)(43). The marked susceptibility of individuals of Northeast Asia descent to KD, compared with the susceptibility of those of European descent, has been maintained following the migration of North Asians to countries where there is a low incidence of the disease (44).…”

Section: Genetics and Kawasaki Diseasementioning

confidence: 99%

Precision Medicine for Kawasaki Disease

Chen

2015

MRAJ

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Kawasaki disease (KD) is a multisystem inflammatory illness of infants and young children that could result in acute vasculitis. Death due to this systemic vasculitis syndrome most frequently results from thrombosed coronary artery aneurysms and coronary arteritis. Without treatment, 25% of children with KD develop coronary artery abnormalities. Current therapy for KD consists of intravenous immunoglobul within the first 10 days of fever onset; this treatment reduces the prevalence of coronary artery abnormalities to 5%. Advances in genetic and proteomic analysis have sparked a worldwide effort to identify genes and potential biomarkers

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“…• Abnormalities of the coronary arteries include ectasia [coronary size larger than normal for age, [normal coronary artery size ranges from1-2mm in newborns and infants to 4.5-5.0 mm in teenagers) [60,61], or aneurysms that may be fusiform or saccular [near -equal axial and lateral diameters) ( Figure 5). Patients with giant aneurysms [internal diameter of at least 8mm] have worst prognosis and are at the greatest risk of developing coronary thrombosis (Figure 6), stenosis, or myocardial infarction.…”

Section: Imaging Studies: An Echocardiogram [Echo]mentioning

confidence: 99%

Kawasaki Disease: The Coronary Affection Perspective

Elshamaa¹

2017

Cardiothorac Vasc Sci

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Kawasaki disease (KD) is an acute, febrile systemic vasculitis of an unknown etiology. KD has now surpassed rheumatic fever as the leading cause of acquired heart disease in the United States (U.S.) among children younger than 5 years. Although there has been a great deal of research into the cause of KD, there is no known etiology. The lack of a diagnostic test can result in significant delays in treatment, often resulting in cardiovascular sequelae ranging from asymptomatic coronary artery ectasis or aneurysm formation to giant coronary artery aneurysms with thrombosis, myocardial infarction, and sudden death in untreated children. Continued research is integral to the evolution of the management of patients with KD because understanding the mechanism of pathogenesis would allow the development of a diagnostic test and, therefore, more rapid and comprehensive treatment. I review these facts and the coronary affection from the diagnostic and the mechanistic standpoints.

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Epidemiology, Etiology, and Management of Kawasaki Disease: State of the Art

Cited by 62 publications

References 91 publications

Hospitalizations for Kawasaki Disease Among Children in the United States, 1988–1997

Hospitalizations for Kawasaki Disease Among Children in the United States, 1988–1997

Precision Medicine for Kawasaki Disease

Kawasaki Disease: The Coronary Affection Perspective

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