Kawasaki Disease

Abstract Kawasaki disease is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in infants and children. If not treated early with high-dose intravenous immunoglobulin, 1 in 5 children develop coronary artery aneurysms; this risk is reduced 5-fold if intravenous immunogl...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2016-04, Vol.67 (14), p.1738-1749
Main Authors: Newburger, Jane W., MD, MPH, Takahashi, Masato, MD, Burns, Jane C., MD
Format: Article
Language:English
Subjects:
Adaptive Immunity
Adrenergic beta-Antagonists - therapeutic use
Age
aneurysm
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Aspirin - therapeutic use
Cardiology
Cardiovascular
coronary aneurysm
Coronary Aneurysm - prevention & control
coronary thrombosis
Coronary Thrombosis - prevention & control
Coronary vessels
Cytokines
Diagnostic Imaging
Epidemiology
Fever
Gangrene
Glucocorticoids - therapeutic use
Health risk assessment
Humans
Illnesses
Immunity, Innate
immunoglobulin
Immunoglobulins
Immunoglobulins, Intravenous - therapeutic use
Internal Medicine
intravenous
Kawasaki disease
Motor Activity
mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - complications
Mucocutaneous Lymph Node Syndrome - diagnosis
Mucocutaneous Lymph Node Syndrome - therapy
myocardial infarction
Myocardial Ischemia - prevention & control
Myocardial Revascularization
Neutrophils
Pathology
Risk Factors
Rodents
Surveillance
Ultrasonic imaging
Veins & arteries
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Description
Summary:Abstract Kawasaki disease is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in infants and children. If not treated early with high-dose intravenous immunoglobulin, 1 in 5 children develop coronary artery aneurysms; this risk is reduced 5-fold if intravenous immunoglobulin is administered within 10 days of fever onset. Coronary artery aneurysms evolve dynamically over time, usually reaching a peak dimension by 6 weeks after illness onset. Almost all the morbidity and mortality occur in patients with giant aneurysms. Risk of myocardial infarction from coronary artery thrombosis is greatest in the first 2 years after illness onset. However, stenosis and occlusion progress over years. Indeed, Kawasaki disease is no longer a rare cause of acute coronary syndrome presenting in young adults. Both coronary artery bypass surgery and percutaneous intervention have been used to treat Kawasaki disease patients who develop myocardial ischemia as a consequence of coronary artery aneurysms and stenosis.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2015.12.073