- Peculiarities of Kawasaki disease in pre-COVID-19 period
Peculiarities of Kawasaki disease in pre-COVID-19 period
Modern Pediatrics. Ukraine. (2024). 5(141): 34-42. doi: 10.15574/SP.2024.5(141).3442
Vakulenko L. I.1, Riznyk A. V.1, Samsonenko S. V.1, Stepanovsky Yu. S.2
1Dnipro State Medical University, Ukraine
2International European University, Kyiv, Ukraine
For citation: Vakulenko LI, Riznyk AV, Samsonenko SV, Stepanovsky YuS. (2024). Peculiarities of Kawasaki disease in pre-COVID-19 period. Modern Pediatrics. Ukraine. 5(141): 34-42. doi: 10.15574/SP.2024.5(141).3442.
Article received: Apr 22, 2024. Accepted for publication: Sep 09, 2024.
Kawasaki disease (KD) is one of the most common causes of fevers of unknown origin and acquired heart defects in children under five years of age. Currently, there are no specific laboratory tests for the diagnosis of KD, so it is established on the basis of clinical data.
Aim – to determine the clinical, laboratory and instrumental features of KD in the pre-modern period in order to optimize treatment.
Materials and methods. Retrospective review of medical histories of 8 children with KD aged 6 months to 5 years (boys – 4, girls – 4). The diagnosis was verified according to the criteria of the American Heart Association, which were approved by the EULAR/PreS Consensus in 2017. Objective and laboratory parameters were examined.
Results. According to the results of the main clinical criteria of KD, febrile fever for more than 5 days, bilateral conjunctival injection without exudation and oropharyngeal changes were observed in all the examined (100%). According to the results of laboratory tests, 100% of the examined had thrombocytosis, 87.5% – anemia, 75.0% – neutrophilic leukocytosis and increased in the erythrocyte sedimentation rate. According to the echocardiological examination of the heart, 100% of the children had signs of dilatation of the heart cavities. Aneurysm of coronary arteries was diagnosed in 37.5% of the examined.
Conclusions. The time of diagnosis of KD determines the therapy and prognosis of the disease. The peculiarities of the course of KD are the cyclic nature and symptoms inherent in many other diseases, which complicates timely diagnosis, leads to the delay of therapy, prolonged hospitalization of patients and worsening of the prognosis.
The study was carried out according to the principles of the Declaration of Helsinki. The study protocol was accepted by the Local Ethical Committee of these institutions. The informed consent of the children's parents was obtained for the research.
The authors declare no conflict of interest.
Keywords: Kawasaki disease, vasculitis, clinic, course, treatment, children.
REFERENCES
1. Ae R, Shibata Y, Kosami K, Nakamura Y, Hamada H. (2021, Dec) Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic. J Pediatr. 239: 50-58.e2. https://doi.org/10.1016/j.jpeds.2021.07.053
2. Buda P, Friedman-Gruszczyńska J, Książyk J. (2021, Nov 30) Anti-inflammatory Treatment of Kawasaki Disease: Comparison of Current Guidelines and Perspectives. Front Med (Lausanne). 8: 738850. https://doi.org/10.3389/fmed.2021.738850
3. Berezhnyi VV, Sovtus KhM, Bondarets YuI. (2017). Modern treatment methods of intravenous immunoglobulin-resistant patients with Kawasaki disease (literature review). Sovremennaya pediatriya. 6(86): 120-124. https://doi.org/10.15574/SP.2017.86.120
4. Chang LY, Lu CY, Shao PL, Lee PI, Lin MT, Fan TY et al. (2014, Mar). Viral infections associated with Kawasaki disease. J Formos Med Assoc. 113(3):148-154. https://doi.org/10.1016/j.jfma.2013.12.008
5. Chatzikyriakidou A, Aidinidou L, Giannopoulos A, Papadopoulou-Legbelou K, Kalinderi K, Fidani L. (2015, Apr). Absence of association of FCGR2A gene polymorphism rs1801274 with Kawasaki disease in Greek patients. Cardiol Young. 25(4):681-683. https://doi.org/10.1017/S1047951114000626
6. Dhillon R, Newton L, Rudd PT, Hall SM. (1993, Dec). Management of Kawasaki disease in the British Isles. Arch Dis Child. 69(6):631-636; discussion 637-638. https://doi.org/10.1136/adc.69.6.631
7. Eleftheriou D, Levin M, Shingadia D, Tulloh R, Klein NJ, Brogan PA. (2014, Jan). Management of Kawasaki disease. Arch Dis Child.99(1):74-83. https://doi.org/10.1136/archdischild-2012-302841
8. Franco A, Touma R, Song Y, Shimizu C, Tremoulet AH et al. (2014, Mar). Specificity of regulatory T cells that modulate vascular inflammation. Autoimmunity.47(2):95-104. https://doi.org/10.3109/08916934.2013.860524
9. Fukazawa R, Kobayashi J, Ayusawa M, Hamada H, Miura M, Mitani Y et al. (2020, Jul 22). Japanese Circulation Society Joint Working Group. JCS/JSCS 2020 Guideline on Diagnosis and Management of Cardiovascular Sequelae in Kawasaki Disease. Circ J. 84(8):1348-1407. https://doi.org/10.1253/circj.CJ-19-1094
10. Kobayashi T, Ayusawa M, Suzuki H, Abe J, Ito S, Kato T et al. (2020, Oct). Revision of diagnostic guidelines for Kawasaki disease (6th revised edition). Pediatr Int. 62(10):1135-1138. https://doi.org/10.1111/ped.14326
11. Kuo HC. (2023, Sep 11). Diagnosis, Progress, and Treatment Update of Kawasaki Disease. Int J Mol Sci. 24(18):13948. https://doi.org/10.3390/ijms241813948
12. Liu FF, Liu HH, Qiu Z, Wang JJ, Samadli S, Wu Y et al. (2020, Apr). Clinical observation of noncoronary cardiac abnormalities in Chinese children with Kawasaki disease. Eur J Clin Invest. 50(4):e13210. https://doi.org/10.1111/eci.13210
13. Melonari P, Abate H, Llano López LH, Cutlca RJ, Apaz MT, Battagliotti C et al. (2019, Oct). Clinical-epidemiological characteristics and predictors of coronary complications in children of Argentina with Kawasaki disease. Rev Chilena Infectol.36(5):636-641. https://doi.org/10.4067/S0716-10182019000500636
14. Mc Crindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M et al. (2017, Apr 25). American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 135(17):e927-e999. https://doi.org/10.1161/CIR.0000000000000484
15. Marchesi A, Rigante D, Cimaz R, Ravelli A, Tarissi de Jacobis I, Rimini A et al. (2021, Jan 25). Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease. Ital J Pediatr. 47(1):16. https://doi.org/10.1186/s13052-021-00962-4
16. Rife E, Gedalia A. (2020, Sep 13). Kawasaki Disease: an Update. Curr Rheumatol Rep. 22(10):75. https://doi.org/10.1007/s11926-020-00941-4
17. Samadli S, Liu FF, Mammadov G, Wang JJ, Liu HH, Wu YF et al. (2019, Jul 31). The time option of IVIG treatment is associated with therapeutic responsiveness and coronary artery abnormalities but not with clinical classification in the acute episode of Kawasaki disease. Pediatr Rheumatol Online J. 17(1):53. https://doi.org/10.1186/s12969-019-0352-3
18. Seki M, Minami T. (2022, Jun 10). Kawasaki Disease: Pathology, Risks, and Management. Vasc Health Risk Manag. 18:407-416. https://doi.org/10.2147/VHRM.S291762
19. Singh S, Jindal AK, Pilania RK. (2018, Jan). Diagnosis of Kawasaki disease. Int J Rheum Dis. 21(1):36-44. https://doi.org/10.1111/1756-185X.13224
20. Stepanovskyy YS, Chernyshova LI, Hilfanova AM, Volokha AP, Bondarenko AV, Sulimanova OS et al. (2018). Kawasaki Disease in Children of Kyiv. Analysis of 23 cases. Sovremennaya pediatriya. 1(89): 116-123. https://doi.org/10.15574/SP.2018.89.116
21. Wang L, Sun X, Cai X, Liu S, Wang Z, Xie Y. (2019, Nov). Atypical manifestations of cardiomegaly and nephrotic syndrome in Kawasaki disease: Two case reports. Medicine (Baltimore).98(48):e18117. https://doi.org/10.1097/MD.0000000000018117
22. Williams M, Nagaraju L, Gorelik M. (2020, Mar 28). Complete Regression of Giant Aneurysms in an Infant with Delayed Diagnosis and Refractory Kawasaki Disease via Combination Anticytokine Therapy: Case Report and Review of Similar Cases. Case Rep Rheumatol.2020:6249013. https://doi.org/10.1155/2020/6249013
23. Wright VJ, Herberg JA, Kaforou M, Shimizu C, Eleftherohorinou H, Shailes H et al. (2018, Oct 1). Immunopathology of Respiratory, Inflammatory and Infectious Disease Study (IRIS) Consortium and the Pediatric Emergency Medicine Kawasaki Disease Research Group (PEMKDRG). Diagnosis of Kawasaki Disease Using a Minimal Whole-Blood Gene Expression Signature. JAMAPediatr.172(10):e182293. https://doi.org/10.1001/jamapediatrics.2018.2293
24. Yu X, Liu X, Wang Y, Lu N, Wang M, Sun L. (2019, Feb). Kawasaki disease complicating bilateral facial nerve palsy and giant coronary artery aneurysms: A case report. Medicine (Baltimore).98(7):e14395. https://doi.org/10.1097/MD.0000000000014395
