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Kawasaki disease: an update on diagnosis and treatment
Ho-Chang Kuo1, Kuender D Yang, Wei-Chiao Chang
1Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
Insights
Kawasaki disease (KD) is a mysterious vasculitis affecting young children, leading to acquired heart disease. This review updates diagnosis and treatment strategies for KD, including options for non-responders.
Area of Science:
- Pediatrics
- Rheumatology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is an acute, multi-system vasculitis of unknown cause, primarily affecting children under five.
- It is the leading cause of acquired heart disease in children in developed nations.
- The etiology of KD remains elusive, with unconfirmed viral links.
Purpose of the Study:
- To review and summarize current knowledge on Kawasaki disease.
- To provide updated information on diagnosis and treatment protocols.
- To discuss advanced treatment options for non-responders to initial therapy.
Main Methods:
- Literature review and synthesis of existing data on Kawasaki disease.
- Inclusion of supplementary diagnostic criteria from the American Heart Association.
- Summary of treatment strategies, including novel therapies for refractory cases.
Main Results:
- Kawasaki disease presents diagnostic challenges, particularly in incomplete forms.
- Intravenous immunoglobulin is a standard treatment, but some patients require alternative therapies.
- Emerging treatments include biologics, corticosteroids, statins, and plasma exchange.
Conclusions:
- Accurate diagnosis and timely treatment are crucial to prevent cardiac complications in Kawasaki disease.
- Management of refractory KD requires a multi-faceted approach with tailored therapeutic options.
- Continued research is needed to elucidate the etiology and optimize treatment of Kawasaki disease.
Abstract:
Kawasaki disease (KD) is an acute multi-system vasculitis syndrome of unknown etiology occurring mostly in infants and children younger than 5 years of age. In developed countries, it is the leading cause of acquired heart disease in children. However, KD remains a mysterious disease. Some viruses potentially causing the condition have been isolated, but the results have not been able to be reproduced. This article reviews and summarizes different aspects of KD and provides updated information on diagnosis and treatment. The supplementary criteria for incomplete presentation of KD patients suggested by the American Heart Association, treatment (including tumor necrosis factor-alpha antagonist, methylprednisolone pulse therapy, statins, plasma exchange, and cytotoxic agents) for those with intravenous immunoglobulin treatment failure, and other experiences are also included in this review.
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