The Clinical Manifestations and Risk Factors of a Delayed Diagnosis of Kawasaki Disease

Juan, Chien Chang; Hwang, Betau; Lee, Pi Chang; Lin, Yu Jan; Chien, Jen Chung; Lee, Hsin Yuan; Meng, Laura C.C.

doi:10.1016/s1726-4901(08)70023-6

Cited by 26 publications

(18 citation statements)

References 15 publications

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“…Various markers, such as % neutrophils, alanine aminotransferase, total bilirubin, serum sodium, and CRP, reportedly associated with initial IVIG failure, [26][27][28] were lower in the late group at baseline in the current study. Similar results were reported by Juan et al 18 However, there was no difference in laboratory parameter improvements between the 2 groups. In particular, the FCs of the WBC count and CRP, which were reported to be associated with CALs, 14 were similar in the 2 groups.…”

Section: Discussionsupporting

confidence: 90%

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Late Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease

et al. 2012

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Section: Discussionsupporting

confidence: 90%

“…[15][16][17][18][19][20] It is more common in younger (,6 months of age) and incomplete KD cases. 16,20 In addition, these have been reported as risk factors for CALs.…”

Section: Discussionmentioning

confidence: 99%

Late Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease

et al. 2012

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“…6,10,11 A study by Newburger et al 11 contributed greatly in this regard, and a single high dose of IVIG is the gold standard therapy in the acute stage of KD. The mechanism of IVIG in reducing inflammation in KD is not clearly understood.…”

Section: Ivigmentioning

confidence: 99%

Recent advances in the treatment of Kawasaki disease

Weng

Lin

et al. 2011

Journal of the Chinese Medical Association

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Kawasaki disease (KD) is acute systemic vasculitis that occurs mainly in infants and children under 5 years of age. The etiology of KD remains unknown. KD is liable to be complicated by coronary artery lesions (CALs), which develop in approximately 15-25% of untreated KD children and in approximately 5% of KD children after intravenous immunoglobulin (IVIG) therapy. A single high dose of IVIG (2 g/kg) is the gold standard therapy in the acute stage of KD. However, approximately 8--38% of children are unresponsive to initial IVIG treatment and at increased risk for CAL development. Anti-inflammatory high doses of aspirin are recommended in conjunction with IVIG, but our study demonstrated that there is no evidence of efficacy in preventing CAL development. The usefulness of steroids in initial therapy for KD or treatment of IVIG-resistant patients is not well established. Other immunosuppressive therapies, including infliximab, have been used in the treatment of refractory KD, but merit additional investigation. Subclinical atherosclerosis may develop early in KD patients, which makes early initiation of therapy to improve chronic inflammation an important issue. Future multicenter studies may help to define the optimal management of KD patients.

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“…This recent epidemiologic data suggests that the incidence of KD and the proportion of its incomplete form tend to increase annually. Incomplete KD has previously been shown to be associated with delayed diagnoses and treatments, which has also been reported to be a risk factor for the development of coronary artery lesions (CALs)5).…”

Section: Introductionmentioning

confidence: 99%

Changes of clinical characteristics and outcomes in patients with Kawasaki disease over the past 7 years in a single center study

2013

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PurposeThis single-center study was conducted to assess the changes in epidemiological and clinical characteristics and outcomes of patients with Kawasaki disease (KD) over the past 7 years.MethodsThis retrospective study included 135 children with KD, admitted to Chungnam National University Hospital, Daejeon, between 2004 and 2005 (group A, n=53) and between 2011 and 2012 (group B, n=82). Medical records were reviewed to obtain information regarding the presenting signs and symptoms, demographic characteristics, and laboratory and echocardiographic findings associated with KD.ResultsThe hospital admission date after onset was significantly earlier in group B than in group A (P=0.008). The proportion of patients with incomplete KD was 45.3% and 65.9% in group A and B, respectively (P=0.018). The number of pretreatment coronary artery lesions (CALs) were significantly lesser in group B than in group A. (10/53 vs. 5/82, P=0.021). No significant differences was observed in the incidence of CALs at discharge, febrile phase duration, hospital stay duration, incidence of retreatment, and intravenous immunoglobulin dose between 2 groups. The total febrile phase was shorter in patients with incomplete KD than in those with complete KD in both groups.ConclusionThe proportion of incomplete KD has become higher. Furthermore, early admission and management of patients with KD may be related to increased incomplete KD and decreased CALs. Therefore, we believe that a diagnostic strategy for incomplete KD should be established regardless of the presence of coronary lesions.

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The Clinical Manifestations and Risk Factors of a Delayed Diagnosis of Kawasaki Disease

Abstract: Patients with delayed diagnosis of KD were associated with higher risk of developing coronary arterial lesions. It is necessary to develop a diagnostic test for KD and provide more education to health care providers for early recognition of KD.

Cited by 26 publications

References 15 publications

Late Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease

Late Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease

Recent advances in the treatment of Kawasaki disease

Changes of clinical characteristics and outcomes in patients with Kawasaki disease over the past 7 years in a single center study

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