Epidemiology, Treatments, and Cardiac Complications in Patients with Kawasaki Disease: The Nationwide Survey in Japan, 2017-2018

Ae, Ryusuke; Makino, Nobuko; Kosami, Koki; Kuwabara, Masanari; Matsubara, Yuri; Nakamura, Yosikazu

doi:10.1016/j.jpeds.2020.05.034

Cited by 116 publications

(108 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although MIS‐C shares clinical features with KD, we demonstrated that these syndromes have important distinct features. As previously reported, we confirmed that MIS‐C affects older children and adolescents, which is in a marked contrast to the epidemiology of KD, occurring predominantly in children 5 years of age or younger and with a peak incidence at 9–11 months of age 45 . Interestingly, the proportions of Hispanic and Black cases were high for MIS‐C with few cases reported in children of Asian descent or in Asian countries in contrast to KD 46 .…”

Section: Discussionsupporting

confidence: 89%

COVID‐19 and multisystem inflammatory syndrome in children: A systematic review and meta‐analysis

Yasuhara

Watanabe

Takagi

et al. 2021

Pediatric Pulmonology

133

128

View full text Add to dashboard Cite

Background Multisystem inflammatory syndrome in children (MIS‐C) associated with coronavirus disease 2019 has been increasingly recognized. However, the clinical features of MIS‐C and the differences from Kawasaki disease remain unknown. The study aims to investigate the epidemiology and clinical course of MIS‐C. Methods PubMed and EMBASE were searched through August 30, 2020. Observational studies describing MIS‐C were included. Data regarding demographic features, clinical symptoms, laboratory, echocardiography and radiology findings, treatments, and outcomes were extracted. Study‐specific estimates were combined using one‐group meta‐analysis in a random‐effects model. Results A total of 27 studies were identified including 917 MIS‐C patients. The mean age was 9.3 (95% confidence interval [CI], 8.4–10.1). The pooled proportions of Hispanic and Black cases were 34.6% (95% CI, 28.3–40.9) and 31.5% (95% CI, 24.8–38.1), respectively. The common manifestations were gastrointestinal symptoms (87.3%; 95% CI, 82.9–91.6) and cardiovascular involvement such as myocardial dysfunction (55.3%; 95% CI, 42.4–68.2), coronary artery aneurysms (21.7%; 95% CI, 12.8–30.1) and shock (65.8%; 95% CI, 51.1–80.4), with marked elevated inflammatory and cardiac markers. The majority of patients received intravenous immunoglobulin (81.0%; 95% CI, 75.0–86.9), aspirin (67.3%; 95% CI, 48.8–85.7), and corticosteroids (63.6%; 95% CI, 53.4–73.8) with a variety of anti‐inflammatory agents. Although myocardial dysfunction improved in 55.1% (95% CI, 33.4–76.8) at discharge, the rate of extracorporeal membrane oxygenation use was 6.3% (95% CI, 2.8–9.8) and the mortality was 1.9% (95% CI, 1.0–2.8). Conclusion Our findings suggest that MIS‐C leads to multiple organ failure, including gastrointestinal manifestations, myocardial dysfunction and coronary abnormalities, and has distinct features from Kawasaki disease.

show abstract

Section: Discussionsupporting

confidence: 89%

COVID‐19 and multisystem inflammatory syndrome in children: A systematic review and meta‐analysis

Yasuhara

Watanabe

Takagi

et al. 2021

Pediatric Pulmonology

133

128

View full text Add to dashboard Cite

show abstract

“…KD is a vasculitis of predominantly medium and small‐sized vessels, capable of causing coronary artery aneurysms (CAA). KD has been reported world‐wide but is most common in Asia, particularly Japan (annual incidence 359 per 100 000 children <4 years old) and children of Asian or Japanese descent living elsewhere 3,4 . In Australia, the incidence varies by ethnic group, but overall is at least 9.34 per 100 000 children <5 years old 5 …”

Section: Kd Is Caused By a Single Aetiological Agent Possibly Sars‐cmentioning

confidence: 99%

“…Patients who are febrile ≥36 h post‐completion of IVIG are considered IVIG‐resistant. IVIG‐resistance occurs in 20% of patients and is associated with higher risk of CAA 4,11 . Unfortunately, clinical trial data do not provide compelling evidence for one particular treatment pathway (Fig.…”

Section: Kd Is Caused By a Single Aetiological Agent Possibly Sars‐cmentioning

confidence: 99%

“…KD has been reported world-wide but is most common in Asia, particularly Japan (annual incidence 359 per 100 000 children <4 years old) and children of Asian or Japanese descent living elsewhere. 3,4 In Australia, the incidence varies by ethnic group, but overall is at least 9.34 per 100 000 children <5 years old. 5 KD is caused by a single aetiological agent, possibly SARS-C0V-2: Probably incorrect KD has been linked with variable veracity to a broad range of infectious agents as well as environmental exposures, including carpet shampoo, genetic variants and meteorological patterns.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Kawasaki disease fact check: Myths, misconceptions and mysteries

Butters

Curtis

Burgner

2020

J Paediatrics Child Health

View full text Add to dashboard Cite

Kawasaki disease (KD) is an important cause of childhood vasculitis and a common cause of acquired heart disease in children world‐wide. The emergence of Paediatric Multisystem Inflammatory Syndrome‐Temporally Associated with SARS‐CoV‐2, a KD‐like hyperinflammatory syndrome and the recent death of Dr Tomisaku Kawasaki make this a timely review. Although KD was described by Dr Kawasaki over 50 years ago, there is still no specific diagnostic test and the aetiology remains elusive. This article summarises the latest evidence, highlights important myths and misconceptions and discusses some of the mysteries that surround this disease.

show abstract

“…10 However, until now, due to the lack of a suitable animal model, no drug has been developed that is useful for improving the prognosis of KD patients who already have CAA. Pathological investigations of KD autopsy cases reported by Orenstein et al demonstrated that luminal myo broblastic proliferation (LMP) was associated with unique smooth muscle cell (SMC)-derived myo broblasts that also caused progressive CA stenosis 11 . Of note, we recently successfully discovered a novel mouse model of CA stenosis induced by Lactobacillus casei cell wall extract (LCWE) to mimic KD.…”

Section: Introductionmentioning

confidence: 99%

All-trans-Retinoic Acid Alleviates Coronary Stenosis by Regulating the Migration of Smooth Muscle Cells in a Mouse Model of Kawasaki Disease

Suganuma

Sato

Honda

et al. 2021

Preprint

View full text Add to dashboard Cite

Coronary artery (CA) stenosis is a detrimental and often life-threatening sequela in Kawasaki disease (KD) patients with coronary artery aneurysm (CAA). Therapeutic strategies for these patients have not yet been established. All-trans-retinoic acid (atRA) is a modulator of smooth muscle cell functions. The purpose of this study was to investigate the effect of atRA on CA stenosis in a mouse model of KD. Lactobacillus casei cell wall extract (LCWE) was intraperitoneally injected into 5-week-old male C57BL/6J mice to induce CA stenosis. Two weeks later, the mice were orally administered atRA (30 mg/kg) 5 days per week for 14 weeks (LCWE+atRA group, n=7). Mice in the untreated group (LCWE group, n=6) received corn oil alone. Control mice were injected with phosphate-buffered saline (PBS, n=5). Treatment with atRA significantly suppressed CA inflammation (19.3±2.8 vs 4.4±2.8, p<0.0001) and reduced the incidence of CA stenosis (100% vs 18.5%, p<0.05). In addition, atRA suppressed the migration of human coronary artery smooth muscle cells (HCASMCs) induced by platelet-derived growth factor subunit B homodimer (PDGF-BB). In conclusion, atRA dramatically alleviated CA stenosis by suppressing SMC migration. Therefore, it is expected to have clinical applications preventing CA stenosis in KD patients with CAA.

show abstract

Epidemiology, Treatments, and Cardiac Complications in Patients with Kawasaki Disease: The Nationwide Survey in Japan, 2017-2018

Cited by 116 publications

References 41 publications

COVID‐19 and multisystem inflammatory syndrome in children: A systematic review and meta‐analysis

COVID‐19 and multisystem inflammatory syndrome in children: A systematic review and meta‐analysis

Kawasaki disease fact check: Myths, misconceptions and mysteries

All-trans-Retinoic Acid Alleviates Coronary Stenosis by Regulating the Migration of Smooth Muscle Cells in a Mouse Model of Kawasaki Disease

Contact Info

Product

Resources

About