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Kawasaki Disease: A Never-ending Story?
Alessandro Cavalcanti Lianza1,2,3, Maria de Fátima Rodrigues Diniz1,4, Karen Saori Shiraishi Sawamura1,2,3
1Echocardiography Laboratory, Instituto da Criança e do Adolescente do Hospital das Clínicas da Universidade de São Paulo São Paulo, Brazil.
Insights
Kawasaki disease can cause coronary artery aneurysms, increasing cardiovascular risks. Long-term monitoring is crucial, even for patients without coronary involvement, due to potential endothelial dysfunction.
Area of Science:
- Pediatrics
- Cardiology
- Inflammatory Disorders
Background:
- Kawasaki disease is an inflammatory condition in children.
- Coronary artery aneurysms are a severe complication, linked to future cardiovascular events.
- Limited data exists on long-term cardiovascular outcomes for patients without coronary involvement or with resolving aneurysms.
Purpose of the Study:
- To review Kawasaki disease aspects.
- To highlight the need for accurate identification, treatment, and monitoring.
- To emphasize risks for patients with potential complications.
Main Methods:
- Literature review of Kawasaki disease.
- Analysis of cardiovascular status in long-term follow-up.
- Evaluation of endothelial function studies.
Main Results:
- Patients with coronary artery aneurysms face higher cardiovascular risks.
- Dysfunctional endothelium suggests a need for continued monitoring in all patients.
- Current follow-up protocols may be insufficient for certain patient groups.
Conclusions:
- Proper identification, treatment, and monitoring of Kawasaki disease patients are essential.
- Long-term cardiovascular surveillance is necessary, particularly for at-risk individuals.
- Further research is needed to clarify long-term outcomes in patients with no or self-limited coronary involvement.
Abstract:
The most severe complication of Kawasaki disease, an inflammatory disorder of young children, is the formation of coronary artery aneurysms. It is known that patients with coronary artery aneurysms, particularly those with medium and large lesions, have a higher risk of future major cardiovascular events. In contrast, there is a lack of data on the cardiovascular status in long-term follow-up for Kawasaki disease patients without coronary involvement or with self-limited coronary artery aneurysms, resulting in most patients being discharged after 5 years. Even though some paediatricians may believe these patients should not be followed at all, studies indicating a dysfunctional endothelium show the need for further investigation. Consequently, a review of the most significant aspects of Kawasaki disease, and the necessity of correctly identifying, treating and monitoring these patients, particularly those with a higher risk of complications, was conducted.
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