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>Journals >Acta Pediátrica de México >Year 2006, Issue 1


Rodríguez HR, Carbajal RL, Reynés MJN, Barrios FR, Zarco RJ
Diagnostic and therapeutic approach of Kawasaki´s disease
Acta Pediatr Mex 2006; 27 (1)

Language: Español
References: 45
Page: 36-349
PDF: 243.26 Kb.


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ABSTRACT

Kawasaki disease (KD) is an acute vasculitis, of unknown etiology of very young children. Its main complication is the formation of coronary artery aneurysms. The diagnosis is eminently clinical based on the presence of fever for a minimum of five days plus four of other five main criteria i.e., 1) erythema, lip fissures, strawberry tongue, pharyngeal hyperemia; 2) conjunctive hyperemia; 3) maculopapular exanthema; 4) extremities erythema, edema, palmar, plantar perianal exfoliation; 5) cervical adenopathy. The diagnosis of atypical or incomplete cases of KD is based on the presence of fever and less than the four criteria required, associated with coronary involvement detected by echocardiography or coronary angiography. Treatment with intravenous gammaglobulina has reduced the prevalence of coronary dilation to less than 5% and of giant aneurysms to less than 1%, while mortality has decreased from 2% to 0.3%. However, some patients who were treated early on develop heart involvement. The purpose of this review is to sensitize the medical profession on this pathology; also to give a detailed description of the diagnostic approaches, and to illustrate most of the clinical features of the disease. Additional manifestations not included in the main approaches are useful to establish an early diagnosis either of classic or of incomplete Kawasaki disease. We discuss the ideal timing to begin treatment, and the indication for the use of intravenous gammaglobulin ten days after the appearance of fever and which patients require larger and/or additional doses of gammaglobulin; to determine which patients require steroids.


Key words: Kawasaki disease, incomplete Kawasaki, coronary aneurysm, intravenous gammaglobulin.


REFERENCIAS

  1. Kawasaki T, Kosaki F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 1974;54:271-6

  2. Rowley AH, Shulman ST. Síndrome de Kawasaki. Clin Pediatr Nort Am 1999;341-59.

  3. Kato H, Sugimura T, Akagi T. Long-term consequences of Kawasaki disease: a 10 to 21-year follow-up study of 594 patients. Circulation 1996;94:1379-85

  4. Leung DYM, Meissner HC, Fulton DR, et al. Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome. Lancet 1993;342:1385–8.

  5. Melish ME, Parsonett J, Marchette N. Kawasaki syndrome (KS) is not caused by toxic shock syndrome toxin-1 (TSST-1)+ staphylococci. Pediatr Res 1994;35:187A.

  6. Terai M, Miwa K, Williams T, et al. The absence of evidence of Staphylococcal toxin involvement in the pathogenesis of Kawasaki disease. J Infect Dis 1995;172:558–61.

  7. Rowley AH, Shulman ST, Spike BT, et al. Oligoclonal IgA response in the vascular wall in acute Kawasaki disease. J Immunol 2001;166:1334–43.

  8. Rowley AH. The etiology of Kawasaki disease: superantigen or conventional antigen. Pediatr Infec Dis J 1999;18:69-70

  9. Mason NH, Takahashi M. Kawasaki Syndrome. Clin Infect Dis. 1999;28:169-87.

  10. Rodríguez HR, Carbajal RL, Reynés MJ, García PC, Barrios FR, Zarco RJ, Belmont ML, Flores DJ. Enfermedad de Kawasaki. Acta Pediatr Mex 2001;22:97-103

  11. Rodríguez HR. Enfermedad de Kawasaki Rev Enf Infec Ped. 2001;57:1-2

  12. Rodríguez HR, Carbajal RL, Barrios FR, Zarco RJ. Síndrome de Kawasaki. Paciente de menor edad reportado en la casuística del Hospital Infantil de México Federico Gómez y Revisión de la literatura. Bol Med Hosp Infant Mex 2002;59:752-4.

  13. Rowley A. Incomplete (atypical ) Kawasaki disease. Pediatr Infect Dis J 2002; 21:563-4

  14. Durongpisitkul K, Gururaj VJ, Park JM, Martin CF. The prevention of coronary artery aneurysm in Kawasaki disease: a meta-analysis on the efficacy of aspirin and immunoglobulin treatment. Pediatrics 1995;96:1057-61

  15. Carbajal RL, Zarco RJ, Luna FM, Rodríguez HR, Barrios FR, Reynés MJ. Las vasculitis. Frecuencia en un hospital de tercer nivel. Acta Pediatr Mex. 2003;24:269–78

  16. Rodríguez HR Kawasaki Disease. In Gonzalez SN, Saltigeral SP, Gómez BD Atlas of Infectious Diseases in Latin American Children. Editorial Prado México. 2005;pp88-91

  17. American Heart Association. AHA Scientific Statement: Diagnostic Guidelines for Kawasaki Disease. Circulation 2001;103:335–6.

  18. Gedalia A. Kawasaki disease: An update. Curr Rheumatol Rep 2002;4:25-

  19. Rosenfeld EA, Corydon KE, Shulman ST. Kawasaki disease in infants less than one year of age. J Pediatr 1995;126:524–9.

  20. Muta H, Ishii M, Sakaue T, Egami K, Furui J, Sugahara Y, Akagi T, Nakamura Y, Yanagawa H, Matsuishi T. Older age is a risk factor for the development of cardiovascular sequelae in Kawasaki disease. Pediatrics 2004;114:751-4

  21. Larralde M, Santos MA, Rutiman R. Kawasaki disease with facial nerve paralysis. Pediatric Dermatology. 2003;20:511-13

  22. Freeman A, Crawford S, Finn L, López AJ, Ferrando MS Perez TD, Cornwall M, Shulman S, Rowley A. Inflammatory pulmonary nodules in Kawasaki disease. Pediatric Pulmonology 2003;36:102-6

  23. Pallasch TJ, Falace DA, Taubert KA et al. Diagnosis, treatment and long-term management of Kawasaki disease: A Statement for Health Professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association Pediatrics 2004;114:1708-33

  24. Han RK, Silverman ED, Newman A, et al. Management and outcome of persistent or recurrent fever after initial intravenous gammaglobulin therapy in acute Kawasaki Disease. Arch Pediatr Adolesc Med 2000;154:694–9.

  25. Fukunishi M, Kikkawa M, Hamana K, Onodera T, Matsuzaki K, Matsumoto Y, Hara J. Prediction of non-responsiveness to intravenous high-dose gammaglobulin therapy in patients with Kawasaki disease at onset. J Pediatr 2000;137:172-6

  26. Mori M, Imagawa T, Yasui K, Kanaya A, Yokota S. Predictors of coronary lesions after intravenous gamaglobulin treatment in Kawasaki disease. J Pediatr 2000;137:177-80

  27. Burns JC, Glode MP. Kawasaki syndrome. Lancet 2004;364:533

  28. Beiser AS, Takahashi M, Baker AL, et al. A predictive instrument for coronary artery aneurysms in Kawasaki disease. US Multicenter Kawasaki Disease Study Group. Am J Cardiol 1998;81:1116

  29. Newburger JW, Taubert KA, Shulman ST, et al. Summary and abstracts of the Seventh International Kawasaki Disease Symposium: December 2001, Hakone, Japan. Pediatr Res 2003;53:153

  30. Burns JC, Capparelli EV, Brown JA, et al. Intravenous gammaglobulin treatment and retreatment in Kawasaki disease. US/ Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J 1998;17:1144

  31. Silva A, Maeno Y, Hashimi A, Smallhorn J, Silverman E, McCrindle B Cardiovascular risk factors after Kawasaki disease: A case control study. J Pediatr 2001;138:400-5

  32. Dedeoglu F, Sundel RP. Vasculitis in children. Pediatr Clin North Am 2005;52:547-57

  33. Shinohara M, Sone K, Tomomasa T, Morikawa A. Corticosteroids in the treatment of the acute phase of Kawasaki disease. J Pediatr 1999;135:465-9

  34. Dale RC, Saleem MA, Daw S, Dillon MJ. Treatment of severe complicated Kawasaki disease with oral prednisolone and aspirin. J Pediatr 2000;137:723-6.

  35. Sundel R, Baker A, Fulton D, Newburger J. Corticosteroids in the initial treatment of Kawasaki disease: report of a randomized trial. J Pediatr 2003;142:611-16

  36. Shulman S. Is there a role for Corticosteroids in Kawasaki disease ? J Pediatr 2003;142:601

  37. Okada Y, Ahnohara M, Kobayashi T, Inoue Y, Tomomasa T, Kobayashi T, Morikawa A. Effect of corticosteroids in addition to intravenous gamma globulin therapy on serum cytokine levels in the acute phase of Kawasaki disease in children. J Pediatr 2003;143:363-7

  38. Weiss JE, Eberhard BA, Chowdhury D, et al. Infiximab as a novel therapy for refractory Kawasaki disease. J Rehumatol 2004;31:808

  39. Williams RV, Wilke VM, Tani LY, et al. Does abciximab enhance regression of coronary aneurysms resulting from Kawasaki disease? Pediatrics 2002;109:E4

  40. Fulton DR, Newburger JW. Long–term cardiac sequelae of Kawasaki disease. Curr Rheumatol Rep 2000;2:324-9

  41. Akagi T, Ogawa S, Ino T, et al. Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation Group. J Pediatr 2000;137:181–6.

  42. Kitamura S. The role of coronary bypass operation on children with Kawasaki disease. Coron Artery Dis 2002;13:437-47

  43. Zhang T, Yanagawa H, Oki I, Nakamura Y. Factors relating to the cardiac sequelae of Kawasaki disease one month after initial onset. Acta Paediatr 2002;91:517-20

  44. Nakano H, Saito A, Veda k, et al: Clinical characteristics of myocardial infarction following Kawasaki disease. J Pediatr 1986;315:341-7

  45. KatoH, Ichinose E, Kawasaki T: Myocardial infarction in Kawasaki disease: Clinical analyses in 195 cases. J Pediatr 1986:108:923-7






>Journals >Acta Pediátrica de México >Year 2006, Issue 1
 

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