Predisposing factors, pathogenesis and therapeutic intervention of Kawasaki disease

Area of Science:

• Pediatric rheumatology
• Immunology
• Cardiology

Background:

• Kawasaki disease (KD) is an acute febrile illness in children.
• It is characterized by inflammation of coronary arteries, potentially leading to abnormalities.
• The exact cause is unknown but involves an abnormal immune response to an infection in genetically susceptible children.

Purpose of the Study:

• To review predisposing factors and pathogenesis of Kawasaki disease.
• To highlight current and emerging therapeutic interventions for KD.
• To focus on novel treatments for patients resistant to intravenous immunoglobulin (IVIG) therapy.

Main Methods:

• Literature review of studies on Kawasaki disease.
• Analysis of pathogenesis, including endothelial cell injury and immune cell activation.
• Evaluation of standard and alternative treatment strategies.

Main Results:

• Standard treatment includes IVIG and aspirin, effective in most cases.
• 10-20% of patients are resistant to IVIG, increasing the risk of coronary vasculitis.
• The efficacy of second IVIG infusions, corticosteroids, and other immunomodulators is still under investigation.

Conclusions:

• Understanding KD pathogenesis is crucial for effective treatment.
• New therapeutic agents are needed for IVIG-resistant KD.
• Further research is required to clarify the roles of various immunomodulatory agents in KD management.