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https://www.readbyqxmd.com/read/28102623/ischemic-stroke-in-kawasaki-disease
#1
Wasana Prangwatanagul, Alisa Limsuwan
Pediatric stroke is considered to be rare. Stroke resulting from cerebral vasculitis is also uncommon in young children. With the increasing prevalence of Kawasaki disease (KD) diagnosis, this acquired vasculitis has been reported with various clinical presentations including neurological symptoms. Herein we describe the case of a KD patient presenting with stroke. A 15-month-old boy was referred due to stroke that occurred on the fifth day of febrile illness. He was initially admitted to another hospital due to fever and diarrhea...
January 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28088248/the-spectrum-of-rheumatic-in-patient-diagnoses-at-a-pediatric-hospital-in-kenya
#2
Angela Migowa, Inés Colmegna, Carol Hitchon, Eugene Were, Evelyn Ng'ang'a, Thomas Ngwiri, John Wachira, Sasha Bernatsky, Rosie Scuccimarri
BACKGROUND: Pediatric rheumatic diseases are chronic illnesses that can cause considerable disease burden to children and their families. There is limited epidemiologic data on these diseases in East Africa. The aim of this study was to assess the spectrum of pediatric rheumatic diagnoses in an in-patient setting and determine the accuracy of ICD-10 codes in identifying these conditions. METHODS: Medical records from Gertrude's Children's Hospital in Kenya were reviewed for patients diagnosed with "diseases of the musculoskeletal system and connective tissue" as per ICD-10 diagnostic codes assigned at discharge between January and December 2011...
January 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28079915/intravenous-immunoglobulin-for-the-treatment-of-kawasaki-disease
#3
Stanford T Shulman
Standard first-line therapy for Kawasaki disease (KD) consists of intravenous immunoglobulin (IVIG) and aspirin. Current guidelines recommend 2 g/kg of IVIG and 80 to 100 mg/kg of aspirin administered within the first 10 days of illness. This regimen has marked efficacy in preventing the development of coronary artery aneurysms. Approximately 15% to 20% of treated patients require a second dose of IVIG to control the inflammatory process. The role of adjunctive corticosteroid therapy with IVIG and aspirin is evolving, with Japanese studies showing a clear benefit in those patients at highest risk for development of coronary disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079914/intravenous-immunoglobulin-in-pediatric-rheumatology-when-to-use-it-and-what-is-the-evidence
#4
Martha M Rodriguez, Linda Wagner-Weiner
Intravenous immunoglobulin (IVIG) is given to children with a variety of rheumatologic illnesses. The mechanism of action by which it exerts therapeutic effects is not well understood and likely differs in the medical conditions for which it is given. IVIG is approved by the US Food and Drug Administration and is the standard of care for Kawasaki disease, but most IVIG use in pediatric rheumatology is "off-label. " The literature supports the use of IVIG for juvenile dermatomyositis, although it is unclear whether its use should be limited to those children with more severe or refractory disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28060166/proposal-of-a-new-pediatric-sequential-organ-failure-assessment-score-for-possible-validation
#5
Nobuaki Shime, Tatsuya Kawasaki, Satoshi Nakagawa
No abstract text is available yet for this article.
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28043682/efficacy-of-four-scoring-systems-in-predicting-intravenous-immunoglobulin-resistance-in-children-with-kawasaki-disease-in-a-children-s-hospital-in-beijing-north-china
#6
Ruixia Song, Wei Yao, Xiaohui Li
OBJECTIVE: To evaluate the predictive efficacies of 4 existing scoring systems for intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD) in hospitalized children with KD in a children's hospital affiliated with the Capital Institute of Pediatrics, Beijing, China. STUDY DESIGN: We retrospectively analyzed 1569 children with KD treated at our children's hospital between January 2010 and December 2015. Age, sex, clinical manifestations, and pretreatment hematologic indicators were recorded...
December 30, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28002448/unique-molecular-patterns-uncovered-in-kawasaki-disease-patients-with-elevated-serum-gamma-glutamyl-transferase-levels-implications-for-intravenous-immunoglobulin-responsiveness
#7
Yue Wang, Zhen Li, Guang Hu, Shiying Hao, Xiaohong Deng, Min Huang, Miao Ren, Xiyuan Jiang, John T Kanegaye, Kee-Soo Ha, JungHwa Lee, Xiaofeng Li, Xuejun Jiang, Yunxian Yu, Adriana H Tremoulet, Jane C Burns, John C Whitin, Andrew Y Shin, Karl G Sylvester, Doff B McElhinney, Harvey J Cohen, Xuefeng B Ling
BACKGROUND: Resistance to intravenous immunoglobulin (IVIG) occurs in 10-20% of patients with Kawasaki disease (KD). The risk of resistance is about two-fold higher in patients with elevated gamma glutamyl transferase (GGT) levels. We sought to understand the biological mechanisms underlying IVIG resistance in patients with elevated GGT levels. METHOD: We explored the association between elevated GGT levels and IVIG-resistance with a cohort of 686 KD patients (Cohort I)...
2016: PloS One
https://www.readbyqxmd.com/read/28000002/stress-perfusion-magnetic-resonance-imaging-to-detect-coronary-artery-lesions-in-children
#8
Chodchanok Vijarnsorn, Michelle Noga, Daryl Schantz, Dion Pepelassis, Edythe B Tham
BACKGROUND: Stress perfusion cardiovascular magnetic resonance (CMR) is used widely in adult ischemic heart disease, but data in children is limited. We sought to evaluate feasibility, accuracy and prognostic value of stress CMR in children with suspected coronary artery disease (CAD). METHODS: Stress CMR was reviewed from two pediatric centers over 5 years using a standard pharmacologic protocol. Wall motion abnormalities, perfusion deficits and late enhancement were correlated with coronary angiogram (CAG) when available, and clinical status at 1 year follow-up for major adverse cardiovascular events (MACE; coronary revascularization, non-fatal myocardial infarction and death due to CAD) was recorded...
December 20, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27997528/losartan-attenuates-the-coronary-perivasculitis-through-its-local-and-systemic-anti-inflammatory-properties-in-a-murine-model-of-kawasaki-disease
#9
Eisuke Suganuma, Fumio Niimura, Shin-Ichi Matsuda, Toshiko Ukawa, Hideaki Nakamura, Kaori Sekine, Masahiko Kato, Yuji Aiba, Yasuhiro Koga, Kuniyoshi Hayashi, Osamu Takahashi, Hiroyuki Mochizuki
BACKGROUND: Kawasaki disease (KD) is a common systemic vasculitis that leads to coronary artery lesions (CALs). Besides its antihypertensive effects, losartan can modulate inflammation in cardiovascular disease. We examined whether losartan can attenuate coronary inflammation in a murine model of KD. METHODS AND RESULTS: Five-week-old C57/BL6J male mice were intraperitoneally injected with Lactobacillus casei cell wall extract (LCWE) to induce coronary inflammation and divided into 4 groups: placebo, IVIG, losartan, and IVIG+losartan...
December 20, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27997519/epidemiology-and-clinical-features-of-kawasaki-disease-in-south-korea-2012-2014
#10
Gi Beom Kim, Sohee Park, Lucy Youngmin Eun, Ji Whan Han, Soo Young Lee, Kyung Lim Yoon, Jeong Jin Yu, Jong-Woon Choi, Kyung-Yil Lee
BACKGROUND: To reveal the recent epidemiologic features of Kawasaki disease (KD) in South Korea based on data from a nationwide survey. METHODS: We collected data between 2012 and 2014 regarding the incidence, symptoms and signs, treatment trends, and coronary complications associated with acute KD by sending questionnaires to 97 hospitals with pediatric residency programs as well as 19 community hospitals without residency training. RESULTS: We received full and partial data from 97 and 13 hospitals, respectively (response rate: 94...
December 15, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27987089/national-survey-of-pediatric-hospitalizations-due-to-kawasaki-disease-and-coronary-artery-aneurysms-in-the-usa
#11
Yusuke Okubo, Kotaro Nochioka, Hiroshi Sakakibara, Marcia Testa, Robert P Sundel
Several studies revealed the epidemiology of Kawasaki disease-related hospitalizations among children in the USA and other countries. However, disparities of developing coronary artery aneurysms by race/ethnicity, patient socioeconomic status, and geographic locations remain unknown in the USA. Hospital discharge record data of patients with Kawasaki disease aged 19 years or younger were obtained from the 2003, 2006, 2009, and 2012 Kid's Inpatient Database. The data were weighted to estimate the annual hospitalization rates with respect to age, gender, and race/ethnicity in the USA...
December 16, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27879314/genetic-variation-in-the-slc8a1-calcium-signaling-pathway-is-associated-with-susceptibility-to-kawasaki-disease-and-coronary-artery-abnormalities
#12
Chisato Shimizu, Hariklia Eleftherohorinou, Victoria J Wright, Jihoon Kim, Martin P Alphonse, James C Perry, Rolando Cimaz, David Burgner, Nagib Dahdah, Long T Hoang, Chiea Chuen Khor, Andrea Salgado, Adriana H Tremoulet, Sonia Davila, Taco W Kuijpers, Martin L Hibberd, Todd A Johnson, Atsushi Takahashi, Tatsuhiko Tsunoda, Michiaki Kubo, Toshihiro Tanaka, Yoshihiro Onouchi, Rae S M Yeung, Lachlan J M Coin, Michael Levin, Jane C Burns
BACKGROUND: Kawasaki disease (KD) is an acute pediatric vasculitis in which host genetics influence both susceptibility to KD and the formation of coronary artery aneurysms. Variants discovered by genome-wide association studies and linkage studies only partially explain the influence of genetics on KD susceptibility. METHODS AND RESULTS: To search for additional functional genetic variation, we performed pathway and gene stability analysis on a genome-wide association study data set...
December 2016: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/27872783/multimodality-cardiac-imaging-in-a-patient-with-kawasaki-disease-and-giant-aneurysms
#13
Ranjini Srinivasan, Rachel Weller, Anjali Chelliah, Andrew J Einstein
Kawasaki disease is a well-known cause of acquired cardiac disease in the pediatric and adult population, most prevalent in Japan but also seen commonly in the United States. In the era of intravenous immunoglobulin (IVIG) treatment, the morbidity associated with this disease has decreased, but it remains a serious illness. Here we present the case of an adolescent, initially diagnosed with Kawasaki disease as an infant, that progressed to giant aneurysm formation and calcification of the coronary arteries...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27833858/neurogenic-pulmonary-edema-combined-with-febrile-seizures-in-early-childhood-a-report-of-two-cases
#14
Keiji Tasaka, Kousaku Matsubara, Masayuki Hori, Hiroyuki Nigami, Aya Iwata, Kenichi Isome, Yu Kawasaki, Sadayuki Nagai
Neurogenic pulmonary edema (NPE) is a clinical entity that can occur following central nervous system disorders. However, NPE occurs quite rarely in early childhood, and there has only been one report about pediatric NPE associated with febrile seizures. Two cases are reported here. One case involved a 2-year-old girl who presented with febrile seizures, which rapidly progressed to severe NPE. Since the NPE occurred in the emergency department room, the patient was able to be resuscitated via immediate endotracheal intubation...
2016: IDCases
https://www.readbyqxmd.com/read/27798729/n-terminal-pro-brain-natriuretic-peptide-can-be-an-adjunctive-diagnostic-marker-of-hyper-acute-phase-of-kawasaki-disease
#15
Hyuksool Kwon, Jin Hee Lee, Jae Yun Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Jung, Ikwan Chang, Kyuseok Kim
: The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively...
December 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27774353/stratification-hypothesis-testing-and-clinical-trial-simulation-in-pediatric-drug-development
#16
Ann W McMahon, Kevin Watt, Jian Wang, Dionna Green, Ram Tiwari, Gilbert J Burckart
BACKGROUND: Pediatric drug development is plagued by small sample sizes, unvalidated clinical endpoints, and limited studies. OBJECTIVES: The objective of this study was to determine whether age stratification within the pediatric population could be used to (1) assess response to a pharmacologic intervention and to (2) design future trials based upon published stratified disease data using clinical trial simulation (CTS). METHODS: Data available from the literature for Kawasaki disease (KD) was used in the model...
2016: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/27704015/pediatric-kawasaki-disease-and-adult-human-immunodeficiency-virus-kawasaki-like-syndrome-are-likely-the-same-malady
#17
Raymond M Johnson, Kelly R Bergmann, John J Manaloor, Xiaoqing Yu, James E Slaven, Anupam B Kharbanda
Background.  Pediatric Kawasaki disease (KD) and human immunodeficiency virus (HIV)(+) adult Kawasaki-like syndrome (KLS) are dramatic vasculitides with similar physical findings. Both syndromes include unusual arterial histopathology with immunoglobulin (Ig)A(+) plasma cells, and both impressively respond to pooled Ig therapy. Their distinctive presentations, histopathology, and therapeutic response suggest a common etiology. Because blood is in immediate contact with inflamed arteries, we investigated whether KD and KLS share an inflammatory signature in serum...
September 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27681743/the-clinical-diagnosis-and-management-of-kawasaki-disease-a-review-and-update
#18
REVIEW
Frank H Zhu, Jocelyn Y Ang
Kawasaki disease is an acute, self-limited vasculitis of childhood and has become the leading cause of acquired pediatric heart disease in the USA. Prompt treatment is essential in reducing cardiac-related morbidity and mortality. The underlying etiology remains unknown. The disease itself may be the characteristic manifestation of a common pathway of immune-mediated vascular inflammation in susceptible hosts. The characteristic clinical features of fever for at least 5 days with bilateral nonpurulent conjunctivitis, rash, changes in lips and oral cavity, changes in peripheral extremities, and cervical lymphadenopathy remain the mainstay of diagnosis...
September 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/27665207/factors-associated-with-resource-utilization-and-coronary-artery-dilation-in-refractory-kawasaki-disease-from-the-pediatric-health-information-system-database
#19
Jennifer Y Lo, L LuAnn Minich, Lloyd Y Tani, Jacob Wilkes, Qian Ding, Shaji C Menon
Management guidelines for refractory Kawasaki disease (KD) are vague. We sought to assess practice variation and identify factors associated with large/complex coronary artery aneurysms (LCAA) and resource utilization in refractory KD. This retrospective cohort study identified patients aged ≤18 years with KD (2004 to 2014) using the Pediatric Health Information System. Refractory KD was defined as receiving >1 dose of intravenous immunoglobulin. Demographics, medications, concomitant infections, length of stay (LOS), and charges were collected...
August 31, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27663723/coronary-artery-bypass-grafting-and-percutaneous-coronary-intervention-after-kawasaki-disease-the-pediatric-canadian-series
#20
A Dionne, M Bakloul, C Manlhiot, B W McCrindle, M Hosking, C Houde, D Pepelassis, N Dahdah
Coronary artery (CA) aneurysms are serious complications of Kawasaki disease (KD) responsible for ischemic events. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are reported with limited data on indications and comparative efficacy. Retrospective multicenter comparison of CA intervention following KD is performed in this study. Twenty two cases were available from 5 centers, of whom 11 underwent CABG, 10 PCI and 1 systemic thrombolysis. Age at intervention (8.3 ± 3.9 vs 11...
September 23, 2016: Pediatric Cardiology
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