Hospitalizations for Kawasaki Syndrome Among Children in the United States, 1997–2007

Holman, Robert C.; Belay, Ermias D.; Christensen, Krista; Folkema, Arianne M.; Steiner, Claudia; Schonberger, Lawrence B.

doi:10.1097/inf.0b013e3181cf8705

Cited by 290 publications

(216 citation statements)

References 19 publications

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“…[19][20][21] An estimated 5523 hospitalizations associated with KD occurred in the United States in 2006, at a mean age of 3 years, for an annual incidence of 20.8 per 100 000 children <5 years of age. 21 The incidence was highest among Asians and Pacific Islanders (30.3 per 100 000 children <5 years of age) and in boys versus girls (24.2 versus 16.8, respectively). 21 Epidemiological comparisons between countries and regions should be viewed in light of often differing methods and completeness of case ascertainment and reporting.…”

mentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

McCrindle¹,

Rowley²,

Newburger³

et al. 2017

Circulation

2,757

4,124

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BACKGROUND:Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS:To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management. Although the cause remains unknown, discussion sections highlight new insights into the epidemiology, genetics, pathogenesis, pathology, natural history, and longterm outcomes. Prompt diagnosis is essential, and an updated algorithm defines supplemental information to be used to assist the diagnosis when classic clinical criteria are incomplete. Although intravenous immune globulin is the mainstay of initial treatment, the role for additional primary therapy in selected patients is discussed. Approximately 10% to 20% of patients do not respond to initial intravenous immune globulin, and recommendations for additional therapies are provided. Careful initial management of evolving coronary artery abnormalities is essential, necessitating an increased frequency of assessments and escalation of thromboprophylaxis. Risk stratification for long-term management is based primarily on maximal coronary artery luminal dimensions, normalized as Z scores, and is calibrated to both past and current involvement. Patients with aneurysms require life-long and uninterrupted cardiology follow-up. CONCLUSIONS:These recommendations provide updated and best evidence-based guidance to healthcare providers who diagnose and manage Kawasaki disease, but clinical decision making should be individualized to specific patient circumstances. K awasaki disease (KD) is an acute, self-limited febrile illness of unknown cause that predominantly affects children <5 years of age. When initially described, the potential for coronary artery complications was not appreciated. KD is now the most common cause of acquired heart disease in children in developed countries. In the absence of pathognomonic tests, the diagnosis continues to rest on the identification of principal clinical findings and the exclusion of other clinically similar entities with known causes. Timely initiation of treatment with intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery aneurysms defined from absolute luminal dimensions from 25% to ≈4%. Ongoing studies with additional therapies have not substantially reduced this residual risk. The long-term prognosis is determined by the initial and current level of coronary artery involvement. Certain subsets of patients are at risk for myocardial ischemia from coronary artery thrombosis and stenoses. Medical management of such patients hinges on judicious use of thromboprophylaxis and vigilance to identify evolving stenoses. Invasive revascul...

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mentioning

confidence: 99%

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

McCrindle¹,

Rowley²,

Newburger³

et al. 2017

Circulation

2,757

4,124

View full text Add to dashboard Cite

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“…4 The annual incidence in Japan is more than 10-fold higher than in the US (20.8) 5 and UK (8.4). 6 It is higher in East Asian countries, and Korea (113.1) 7 and Taiwan (69.0) 8 have the second and the third highest annual incidence of KD.…”

Section: Epidemiologic Data Suggesting Genetic Component Of Kdmentioning

confidence: 99%

“…9 On the other hand, the incidence among white children in Hawaii was 13.7, which was comparable with that in the US mainland (12.0). 10 High relative risk of KD among the family members of a KD patient is also known. Siblings of a KD patient are at 10-30-fold higher risk of KD compared with the general population.…”

Section: Epidemiologic Data Suggesting Genetic Component Of Kdmentioning

confidence: 99%

Genetics of Kawasaki Disease

Onouchi

2012

Circ J

110

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Kawasaki disease (KD) is a leading cause of acquired heart disease in children in developed countries. Although it has been thought that symptoms of KD are related to hyperactivation of the immune system triggered by infection with some microorganisms, the etiological agent still remains unknown. In this situation, genetic factors underlying the disease pathogenesis, which have been suggested by epidemiological findings, are expected to be clues to the enigma. Recently, susceptibility genes for KD have been identified in succession by studies with a genome-wide approach. Recent advances in genetic studies for KD will be presented. (Circ J 2012; 76: 1581 - 1586

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“…Other causative agents include bacteria, fungi and house mites. 6 In the last decades, an increase in the incidence of KD in Japan, 7 the United States, 8 and Europe has been observed. 9 The incidence in European countries ranges from 5-8/100,000 children under the age of 5 years.…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile of Kawasaki Disease (KD) in Children admitted at Dhaka Shishu Hospital

Miah

Hoque

Islam

et al. 2017

Northern Int. Med. Coll. J.

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Hospitalizations for Kawasaki Syndrome Among Children in the United States, 1997–2007

Cited by 290 publications

References 19 publications

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Genetics of Kawasaki Disease

Clinical Profile of Kawasaki Disease (KD) in Children admitted at Dhaka Shishu Hospital

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