1.Epidemiological and clinical characteristics of Kawasaki disease in children
Van Hai Dang ; Tra Nam Le ; Ha Sy Ho
Journal of Medical Research 2007;55(6):26-33
Background:Kawasaki is acute fever disease with systematic vein infection which often seen in children under 5 years old. Objectives:Describe the clinical characteristics and laboratory, echocardiography data in children with Kawasaki between early diagnosed group and late one. Subjects and method: A descriptive, prospective study was carried out on 77 Kawasaki disease patients were selected, including 50 patients were diagnosed before day 10 of illness (group 1) and 27 patients were diagnosed on or after day 10 (group 2) in the National Pediatrics hospital from June 2004 to June 2006. Results:The mean was 13.4 months. Age under 12 months was 61 %. Male/female ratio was 1.7: 1. Fever, red lips, red eyes, skin rash, extremities edema and cervical lymphadenopathy occurred in the first week. The inflammatory response was strong (CRP: 83.6 mg/I, erythrocyte sedimentation rate (ESR) after an hour: 79.1 mm. WBC: 27800/ mm3). There were no differences between patients in the group 1 and group 2 in age, gender, time to the first medical visit, C-reactive protein (CRP) concentration, white blood cell count or erythrocyte sedimentation rate. Patients in the group 1 had significantly close clustering of symptoms onset in the first few days of illness, but patients in the group 2 had onset of symptoms scattered over 4 days. A platelet count of over 500.000/mm3 occurred more often in the group 2 (60%) than the group 1 (31.3%). Coronary involvement was observed in 23 patients (29.8%) including 17 patients who had coronary dilation and 6 patients with coronary aneurysm. Conclusion:Coronary artery abnormalities in the group 2 (48.1%) occurred significantly more than the group 1 (20%).
Mucocutaneous Lymph Node Syndrome/ diagnosis
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pathology
;
Child
2.Coronary lesion in Kawasaki disease in children
Van Hai Dang ; Tra Nam Le ; Ha Sy Ho
Journal of Medical Research 2007;55(6):13-20
Background: Kawasaki is an acute fever disease with systematic vein infection and often seen in children.Objectives:This study aims to determine features and risk factors of coronary artery lesion (CAL) in Kawasaki disease in children. Subjects and method:A descriptive, prospective study was conducted on 83 patients diagnosed with Kawasaki disease whom treated at National Hospital for Pediatric from January 2005 to March 2007. They were divided into 2 groups: with and without CAL. All data from clinical characteristics, laboratory and echocardiography were analyzed to evaluate the differences between 2 groups. Univariate and multivariate analysis were used. Results: Among 83 patients diagnosed with Kawasaki disease, 27 patients (32.5%) was found with CAL. 24 patients (88.9%) had both right and left coronary artery abnormalities. The CAL in left anterior descending (LAD) and in left circumflex coronary artery (LCX) was 55.6% and 25.9% respectively. Risk level II: 7 patients (25.9%). Risk level III: 14 patients (51.9%) and risk level IV: 6 patients (22.2%). 14 patients (51.9%) with CAL were resolved at 6th month of the illness. Independent risk factors of CAL in acute stage included age under 12 months (OR = 3.97, p<0.05). IVIG treatment was within the first 10 day of the illness (OR=0.25, p<0.05). Non - responsiveness to \u03b3globulin therapy (OR=7.69, p<0.01). CRP before starting initial treatment above 90mg/1 (OR = 12.81, p<0.05). Platelets before starting \u03b3 globulin therapy ~ 557 000/ mm3 with OR=4.73 and p<0.05. Conclusion:Early detection and treatment were necessary in order to decrease CAL in patients with Kawasaki disease.
Mucocutaneous Lymph Node Syndrome/ diagnosis
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pathology
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Coronary Vessels/ pathology
;
Child
3.Research advances in the pathogenesis of familial Kawasaki disease.
Ke CAI ; Feng WANG ; Yong-Hao GUI
Chinese Journal of Contemporary Pediatrics 2018;20(7):594-597
Kawasaki disease has become the leading cause of acquired heart disease in children in North America and Japan. The incidence rate of Kawasaki disease varies significantly across regions and races. The first-degree relatives of patients with Kawasaki disease have a significantly higher risk of this disease than the general population. This article reviews the onset of familial Kawasaki disease and possible pathogenesis.
Animals
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Humans
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Mucocutaneous Lymph Node Syndrome
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complications
;
genetics
;
immunology
;
pathology
6.Kawasaki Disease Mimicking Retropharyngeal Abscess.
Ramaswamy GANESH ; Vazhkudai Sridharan SRIVIDHYA ; Thiruvengadam VASANTHI ; Somu SHIVBALAN
Yonsei Medical Journal 2010;51(5):784-786
Kawasaki disease is an acute, self-limiting febrile mucocutaneous vasculitis of infants and young children. Retropharyngeal lymphadenopathy is a rare presentation of Kawasaki disease. We present a case of Kawasaki disease mimicking a retropharyngeal abscess, with upper airway obstruction resulting in delayed diagnosis.
Child
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Humans
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Male
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Mucocutaneous Lymph Node Syndrome/*diagnosis/*pathology
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Retropharyngeal Abscess/*pathology
9.Platelet-to-lymphocyte ratio as a biomarker for predicting coronary artery lesions in Chinese children with Kawasaki disease: a Meta analysis.
Yan-Yu LI ; Chen-Chen YUAN ; Ai-Yuan CAI ; Bo-Ju ZHOU ; Teng HUANG
Chinese Journal of Contemporary Pediatrics 2023;25(12):1219-1226
OBJECTIVES:
To systematically evaluate the value of the platelet-to-lymphocyte ratio (PLR) in predicting coronary artery lesions (CAL) in Chinese children with Kawasaki Disease (KD).
METHODS:
A comprehensive search was conducted in databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, China Biomedical Literature Database, and China Science and Technology Journal Database from inception to December 2022. The quality of the included literature was assessed using the Newcastle-Ottawa Scale, and a Meta analysis was performed using Stata 15.1.
RESULTS:
A total of ten published reports, involving 3 664 Chinese children with KD, were included in this Meta analysis, of whom 1 328 developed CAL. The Meta analysis revealed a sensitivity of 0.78 (95%CI: 0.71-0.83), specificity of 0.71 (95%CI: 0.61-0.80), overall diagnostic odds ratio of 8.69 (95%CI: 5.02-15.06), and an area under the curve of the summary receiver operating characteristic of 0.82 (95%CI: 0.78-0.85) for PLR in predicting CAL in the children with KD. The sensitivity, specificity, and area under the curve of summary receiver operating characteristic were lower for PLR alone compared to PLR in combination with other indicators. Sensitivity analysis demonstrated the stability of the Meta analysis results with no significant changes upon excluding individual studies. However, a significant publication bias was observed (P<0.001).
CONCLUSIONS
PLR demonstrates certain predictive value for CAL in Chinese children with KD.
Child
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Humans
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Mucocutaneous Lymph Node Syndrome/pathology*
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Coronary Vessels/pathology*
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Lymphocytes
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Biomarkers
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China
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Coronary Artery Disease/pathology*
10.Pediatric expert consensus on the application of aspirin in Kawasaki disease.
Chinese Journal of Contemporary Pediatrics 2022;24(6):597-603
Kawasaki disease (KD) is one of the common acquired heart diseases in children aged <5 years and is an acute systemic vasculitis. After nearly 60 years of research, intravenous immunoglobulin combined with oral aspirin has become the first-line treatment for the prevention of coronary artery lesion in acute KD; however, there are still controversies over the role and optimal dose of aspirin. The consensus was formulated based on the latest research findings of KD treatment in China and overseas and comprehensive discussion of pediatric experts in China and put forward recommendations on the dose, usage, and course of aspirin treatment in the first-line treatment of KD.
Aspirin/therapeutic use*
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Child
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Consensus
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Coronary Vessels/pathology*
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Humans
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Immunoglobulins, Intravenous/therapeutic use*
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Mucocutaneous Lymph Node Syndrome/pathology*