Kawasaki Disease and Coronary Artery Aneurysms: From Childhood to Adulthood

Joshi, Manjiri; Tulloh, Robert

doi:10.2217/fca-2017-0039

Cited by 6 publications

(6 citation statements)

References 84 publications

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“…The most serious complication in patients with KD was heart attack caused by coronary artery aneurysm whose underlying molecular mechanism had not been elucidated clearly. 1 , 24 However, coronary artery dysfunction caused by cardiovascular inflammation that was induced by inflammatory factor infiltration was confirmed to be a leading cause of coronary artery lesion. 24 , 25 In the process of angiogenesis and remodeling, there were close and complex interactions among vascular endothelial cells, extracellular matrix, inflammatory cells and related inflammatory factors.…”

Section: Discussionmentioning

confidence: 99%

FNDC1 Polymorphism (rs3003174 C > T) Increased the Incidence of Coronary Artery Aneurysm in Patients with Kawasaki Disease in a Southern Chinese Population

Lin¹,

Zhang²,

Wang³

et al. 2021

JIR

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Background A large number of studies demonstrated that the key to the occurrence and development of Kawasaki disease (KD) is the over-activation of immune cells and the generation of various inflammatory factors, leading to the imbalance of the immune system. Recently, mutations in the FNDC1 gene have been shown to be associated with inflammatory responses. However, there have been no reports on the relationship between FNDC1 gene and KD so far. Methods We enrolled 1611 controls and 1459 patients with KD, including 372 patients with coronary artery aneurysm (CAA) and 179 patients with coronary artery lesion (CAL). The relationship between FNDC1 rs3003174 polymorphism and KD with CAA or without CAA was investigated. Results This study showed no evidence that the association between FNDC1 rs3003174 C>T polymorphism and KD susceptibility was statistically significant (CT versus CC: adjusted odds ratio (OR) =0.897, 95% confidence interval (CI) =0.769–1.045, P=0.162; TT versus CC: adjusted OR=0.995, 95% CI=0.786–1.260, P=0.968; dominant model: adjusted OR=0.916, 95% CI=0.792–1.059, P=0.235; and recessive model: adjusted OR=1.055, 95% CI=0.845–1.316, P=0.638). However, our further stratified analysis in the control and KD group bore out that the incidence of TT genotype of FNDC1 rs3003174 C > T polymorphism was higher than that of CC/CT genotype in KD patients stratified by CAA (adjusted OR=1.437, 95% CI=1.034–1.996, P=0.031). Moreover, a stratified analysis of age and gender in KD patients indicated that the rs3003174 TT genotype increased the risk of CAA formation in aged ≦60 months (CC/CT vs TT: adjusted OR=1.580, 95% CI=1.106–2.259, P=0.012) and male (CC/CT vs TT: adjusted OR=1.653, 95% CI=1.101–2.481, P=0.015) KD patients. Conclusion The results of this study demonstrated that the FNDC1 rs3003174 C>T polymorphism may be a hazard factor in the formation of CAA in KD patients that was not disclosed before.

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Section: Discussionmentioning

confidence: 99%

FNDC1 Polymorphism (rs3003174 C > T) Increased the Incidence of Coronary Artery Aneurysm in Patients with Kawasaki Disease in a Southern Chinese Population

Lin¹,

Zhang²,

Wang³

et al. 2021

JIR

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“… 25 The psychological distress is associated with family characteristics, such as family income and maternal education. 26 Children with persistent CAL may develop complications, 11 so caregivers may worry, feel stressed and experience helplessness with regard to facing the uncertainty of their children’s risk of myocardial infarction and the possibility of sudden death. This finding suggests that the parental stress or mental health of caregivers of patients with CAL require particular assistance.…”

Section: Discussionmentioning

confidence: 99%

“… 10 These studies suggest that 20%–24% of children with KD, even when treated with IVIG, still suffer from CAL and 4% with coronary artery aneurysm formation. 11 12 …”

Section: Introductionmentioning

confidence: 99%

Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study

et al. 2021

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ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.

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“…The psychological distress is associated with family characteristics, such as family income and maternal education [26]. Children with persistent CAL may develop complications [11], so caregivers may worry, feel stressed, and experience helplessness with regard to facing the uncertainty of their children's risk of myocardial infarction and the possibility of sudden death. This nding suggests that the parental stress or mental health of caregivers of patients with CAL require particular assistance.…”

Section: Discussionmentioning

confidence: 99%

“…Intravenous immunoglobulin (IVIG) infusion has been established as the standard treatment for acute KD [8], but 10-20% of patients still show resistance to IVIG therapy and are at high risk for coronary artery complications [9], of which, the formation of coronary artery lesions (CAL) is the most serious [10]. Current studies suggest that 20-24% of KD children, even when treated with IVIG, still suffer from CAL [11,12].…”

Section: Introductionmentioning

confidence: 99%

Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers

Wang

Tsai

Chang

et al. 2020

Preprint

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Background Kawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multi-systemic vasculitis common in KD patients may influence blood perfusion in the brain, and thus caregivers of KD children may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (CAL). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress. Methods This cross-sectional study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% male) and 85 healthy children (mean age: 6.4 years, 54.1% male). Based on the children’s age, each KD patient and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index-Short Form (PSI). Results We observed no significant differences in any developmental index, cognitive function, or parenting stress between KD patients and controls. Among the KD children, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL (p = 0.019). Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college (p = 0.010) or lower (p = 0.021). Conclusion No significant differences in developmental index, cognitive function or parenting stress between KD patients and controls. In KD patients, neither IVIG response nor CAL appear to have a relationship with development milestones or cognitive function. However, caregivers’ education is associated to parenting stress, and caregivers of KD patients who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfill their parenting roles.

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Kawasaki Disease and Coronary Artery Aneurysms: From Childhood to Adulthood

Cited by 6 publications

References 84 publications

FNDC1 Polymorphism (rs3003174 C > T) Increased the Incidence of Coronary Artery Aneurysm in Patients with Kawasaki Disease in a Southern Chinese Population

FNDC1 Polymorphism (rs3003174 C > T) Increased the Incidence of Coronary Artery Aneurysm in Patients with Kawasaki Disease in a Southern Chinese Population

Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study

Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers

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