Kawasaki disease with severe cardiac sequelae: Lessons from recent New Zealand experience

Wilson, Nigel; Heaton, Paul Anthony; Calder, Louise; Nicholson, Ross; Stables, Simon; Gavin, R

doi:10.1111/j.1440-1754.2004.00456.x

Cited by 21 publications

(25 citation statements)

References 20 publications

(28 reference statements)

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“…Evidence suggests that delaying therapy for KD is associated with increased risk of treatment failure and for development of coronary artery aneurysms 17, 18. Our results underscore the need for considering IVIG therapy in children with a high index of suspicion for KD even in the absence of all classic symptoms and with documented respiratory viral infections.…”

Section: Discussionsupporting

confidence: 53%

Concomitant Respiratory Viral Infections in Children With Kawasaki Disease

Jordán-Villegas

Chang

Ramilo

et al. 2010

Pediatric Infectious Disease Journal

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The role of respiratory viruses in the pathogenesis of Kawasaki disease (KD) remains controversial. In this study we showed that 8.8 % of KD patients had documented respiratory viral infections. Patients with concomitant viral infections had a higher frequency of coronary artery dilatations and were significantly more often diagnosed with incomplete KD. The presence of a concomitant viral infection should not exclude the diagnosis of KD.

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Section: Discussionsupporting

confidence: 53%

Concomitant Respiratory Viral Infections in Children With Kawasaki Disease

Jordán-Villegas

Chang

Ramilo

et al. 2010

Pediatric Infectious Disease Journal

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“…18,19 Fewer patients received IVIG within 10 days in the younger age group. Delayed and incomplete clinical presentation postpones IVIG treatment.…”

Section: Treatment and Outcome In Infants Younger Than 6 Monthsmentioning

confidence: 98%

Characteristics of Kawasaki Disease in Infants Younger than Six Months of Age

Chang

Hwang

Chen

et al. 2006

The Pediatric Infectious Disease Journal

135

107

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Infants younger than 6 months with prolonged unexplained febrile illnesses should be suspected as having Kawasaki disease, despite the incomplete clinical presentation. Because early diagnosis and timely treatment are difficult in younger infants with Kawasaki disease because of delayed and incomplete clinical presentations, echocardiogram becomes an important implement for diagnosis. Early intravenous immunoglobulin treatment is required in view of the highest risk of coronary involvement in them.

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“…Healing and fibrosis of the affected coronary arteries is seen later, leading to stenosis formation, particularly in the post-aneurysmal segment of the artery, with the associated risk of coronary thrombosis, myocardial infarction and sudden death 58. Progressive intimal hyperplasia can be seen many years after the initial episode of KD 59.…”

Section: Acute Cardiac Sequelae Of Kdmentioning

confidence: 99%

Kawasaki disease in children

Wood

Tulloh

2008

Heart

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Kawasaki disease (KD) is an acute self-limiting systemic vasculitis of unknown aetiology. It is the most common cause of acquired heart disease in young children. The intense inflammatory process has a predilection for the coronary arteries, resulting in the development of aneurysmal lesions, arterial thrombotic occlusion or, potentially, sudden death. There is no specific diagnostic test; however, treatment with immunoglobulin and aspirin effectively reduces cardiac complications from 25% to 4.7% in the UK. Inflammation of the myocardium, endocardium or pericardium can occur early in the disease and endothelial dysfunction along with abnormalities of myocardial blood flow may require continuing medication, interventional catheterisation or even cardiac surgery. Several new pharmacological treatments may have important roles to play in managing KD in children and adolescents. This review discusses the history of the disease, the diagnostic challenges, epidemiology, aetiology, pathology, immunopathogenesis, treatment, genetic influences and the long-term cardiovascular sequelae.

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Kawasaki disease with severe cardiac sequelae: Lessons from recent New Zealand experience

Abstract: Kawasaki disease remains an important cause of mortality and morbidity for children. Diagnostic delay beyond 8 days reduces the chances of successful IVIG therapy in KD. Current studies supported by the Paediatric Surveillance Unit should establish the epidemiology of KD in New Zealand.

Cited by 21 publications

References 20 publications

Concomitant Respiratory Viral Infections in Children With Kawasaki Disease

Concomitant Respiratory Viral Infections in Children With Kawasaki Disease

Characteristics of Kawasaki Disease in Infants Younger than Six Months of Age

Kawasaki disease in children

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