Kawasaki disease shock syndrome: a rare and severe complication of Kawasaki disease

Çakan, Mustafa; Gemici, Hakan; Aktay-Ayaz, Nuray; Keskindemirci, Gonca; Bornaun, Helen; İkizoğlu, Tarkan; Çeliker, Alpay

doi:10.24953/turkjped.2016.04.012

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Heparin anticoagulation [10 U/(kg.d) of heparin concurrently two h before the start of methylprednisolone] for 24 h is recommended, or low-molecular heparin anticoagulation with coagulation, echocardiography, and blood pressure monitoring (2A). [47][48][49][50] First-line treatment of KD combined with MAS Recommendation: Methylprednisolone 10-30 mg/ (kg.d) for 3 d, with each IV infusion for 2-3 h. Sequential prednisone orally [1-2 mg/(kg.d)] until complete control and remission of MAS with gradual dose reduction and discontinuation (2A) [51][52][53] GC is not recommended as routine first-line therapy for KD. GC alone is unsafe and contraindicated as a first-line treatment for KD, as studies have shown that GC alone used as an initial treatment for KD can significantly increase coronary artery damage.…”

Section: Bmentioning

confidence: 99%

Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid

Ren,

Deng,

et al. 2024

Eur J Clin Exp Med

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Introduction and aim. Kawasaki disease (KD) is an acute vasculitis with unknown etiology, usually occurring in chil dren under 5 years old. This article will summarize the three consensuses formulated in China about KD. Material and methods. English databases for consensus search include UpToDate, BMJ Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed, etc.; Chinese databases in clude China Biomedical Literature Service, China Knowledge Network, Wanfang database, etc. All literature searches ended on February 28, 2022. Analysis of the literature. KD is a common acquired heart disease in children and can lead to severe complications such as coronary injury. However, intravenous immunoglobulin (IVIG) combined with oral aspirin (Asp) is currently recognized as the most effective treatment in KD acute stage and the first-line treatment to prevent cardiovascular complications. Glucocorticoid (GC) is mainly used for KD patients with a high risk of coronary artery aneurysm (CAA), no immunoglobulin response, and confirmed CAA. There are already consensus guidelines on diagnosing and treat ing KD in different countries. This article summarizes the relevant expert consensus on aspirin, glucocorticoids and IVIG for the treatment of Kawasaki disease in China. Conclusion. Still, there are inconsistent opinions in the literature on the mechanism, optimal timing, and dosage of medication for KD.

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Section: Bmentioning

confidence: 99%

Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid

Ren,

Deng,

et al. 2024

Eur J Clin Exp Med

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“…Some investigators, including Todd et al [58], who named TSS, have described cases of KS superimposed on TSS [59]. Additionally, there have been multiple reports of a KS-shock syndrome [60,61].…”

Section: Laboratory Findings In Ksmentioning

confidence: 99%

Kawasaki syndrome: role of superantigens revisited

Leung

Schlievert

2020

The FEBS Journal

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Kawasaki Syndrome (KS) is an acute vasculitis in children complicated by the development of heart disease. Despite its description over 50 years ago, the etiology of coronary artery disease in KS is unknown. High dose intravenous immunoglobulin is the most effective approach to reduce cardiovascular complications. It remains unclear why patients with KS develop coronary artery aneurysms. A subset of patients are resistant to immunoglobulin therapy. Given the heterogeneity of clinical features, variability of history, and therapeutic response, KS may be a cluster of phenotypes triggered by multiple infectious agents and influenced by various environmental, genetic, and immunologic responses. The cause of KS is unknown, and a diagnostic test remains lacking. A better understanding of mechanisms leading to acute KS would contribute to a more precision medicine approach for this complex disease. In the current viewpoint, we make the case for microbial superantigens as important causes of KS.

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“…Myocarditis is nearly universal in acute phase of KD and, at times, it can be severe and symptomatic[ 58 , 59 ]. These patients are usually admitted in intensive care units with cardiovascular collapse and may be mistakenly treated for bacterial sepsis and septic shock[ 13 , 60 , 61 ]. As a result, the diagnosis of KD gets delayed and this can have serious consequences.…”

Section: Controversies In Diagnosis Of Kdmentioning

confidence: 99%

Controversies in diagnosis and management of Kawasaki disease

Pilania

Bhattarai

Singh

2018

WJCP

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Kawasaki disease (KD) is a common medium vessel systemic vasculitis that usually occurs in small children. It has a predilection for the coronary arteries, but other medium sized arteries can also be involved. The etiology of this disorder remains a mystery. Though typical presentation of KD is quite characteristic, it may also present as incomplete or atypical disease in which case the diagnosis can be very challenging. As both incomplete and atypical forms of KD can be associated with serious coronary artery complications, the pediatrician can ill afford to miss these diagnoses. The American Heart Association has enunciated consensus guidelines to facilitate the clinical diagnosis and treatment of this condition. However, there are still several issues that remain controversial. Intravenous immunoglobulin remains the cornerstone of management but several other treatment modalities, especially glucocorticoids, are increasingly finding favour. We review here some of the contemporary issues, and the controversies thereon, pertaining to management of KD.

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Kawasaki disease shock syndrome: a rare and severe complication of Kawasaki disease

Cited by 6 publications

References 7 publications

Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid

Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid

Kawasaki syndrome: role of superantigens revisited

Controversies in diagnosis and management of Kawasaki disease

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