Aetiology of Kawasaki disease.

Thirteen serum samples from nine children with Kawasaki disease and 23 control samples gave negative results on screening for antibodies to hog cholera virus, border disease of sheep, bovine diarrhoea virus, and equine arteritis virus. The sera from two children with Kawasaki disease were cytotoxic; a possible link with cytotoxin from Propionibacterium acnes is considered.     

丙种球蛋白无反应型川崎病治疗及随访分析

目的了解丙种球蛋白(IVIG)无反应型川崎病患儿追加IVIG和追加激素治疗对其冠状动脉的影响及预后。方法将住院治疗的确诊为IVIG无反应型川崎病患儿32例,根据进一步治疗方案的不同分为A组(追加IVIG组,22例)、B组(追加激素组,10例),对两组患儿进行门诊随访。结果 B组恢复期(21～60 d)冠状动脉损害(CAL)发生率高于A组(P=0.035),两组随访半年后CAL发生率差别无统计学意义(P=0.128)。随访5年后,A组中7例从发病至随访结束冠状动脉均无异常,11例冠状动脉损害恢复正常,4例仍有冠状动脉异常;B组中6例冠状动脉损害恢复正常,4例仍有冠状动脉异常。结论两种方案治疗IVIG无反应型川崎病均有效,两组冠状动脉远期损害未发现有差异;IVIG无反应型川崎病患儿后期仍有CAL进展的可能,应加强长期随访。     

Kawasaki disease in siblings.

We report a case of mucocutaneous lymph node syndrome, which was diagnosed in a 13 month old boy two years after the death of his sister from the same disease.     

Kawasaki disease

PURPOSE OF REVIEW: Kawasaki disease is an acute, self-limited vasculitis of childhood characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in approximately 15 to 25% of untreated children with the disease and may lead to myocardial infarction, sudden death, or ischemic heart disease. RECENT FINDINGS: In the United States, Kawasaki disease has now surpassed acute rheumatic fever as the leading cause of acquired heart disease in children. The cause of Kawasaki disease remains unknown, but fortunately intravenous immune globulin therapy has proved to be effective at reducing the prevalence of coronary aneurysms in most children treated in the acute phase. Therapy for Kawasaki disease resistant to intravenous immune globulin therapy is an area of research and controversy. The long-term treatment of children with Kawasaki disease is dependent on coronary artery status. SUMMARY: This review covers key data on the etiology, pathogenesis, treatment, and long-term outcomes of Kawasaki disease, highlighting recent publications.     

Kawasaki disease

Kawasaki disease is a systemic vasculitis and the leading cause of acquired heart disease in North American and Japanese children. The epidemiology, cause, and clinical characteristics of this disease are reviewed. The diagnostic challenge of Kawasaki disease and its implications for coronary artery outcomes are discussed, as are the recommended treatment, ongoing treatment controversies, concerns associated with treatment resistance, and the importance of ongoing follow up.     

Infantile polyarteritis and Kawasaki disease.

Polyarteritis in infancy is very rare, difficult to diagnose and invariably fatal. A 6-month-old girl who presented with a prolonged unexplained fever and was subsequently demonstrated at post-mortem examination to have polyarteritis is described. The combination of polyarterits with some unusual presenting features suggests that the case described is one of the Mucocutaneous Lymph Node Syndrome (M.L.N.S.) or Kawasaki Disease. Polyarteritis and Kawasaki Disease are discussed with reference to the case described.     

Kawasaki disease

Kawasaki disease (KD) is a systemic necrotizing vasculitis affecting medium and small sized arteries. 13 The diagnosis is based entirely on recognition of a typical sequence of clinical features. Detection of any one clinical feature does not have any diagnostic significance. We report an uncommon case of Kawasaki disease in 10 months old male child with the analysis of its natural history, etiopathology, treatment and prognosis of the disease.     

Recurrent skin peeling following Kawasaki disease.

Long term follow up of 259 cases of Kawasaki disease led to the observation that 11% of children have episodes of recurrent peeling of the skin for several years after their recovery. These events were usually associated with an upper respiratory tract infection and were distinct from a recurrence of Kawasaki disease. Repeeling was significantly less frequent in children who had suffered coronary artery dilatation and was more frequently seen in those with nasal staphylococcal colonisation. The mechanism for this phenomenon is unclear, but it has been observed in a number of other conditions caused by infectious agents and their toxins. Paediatricians need to be aware of this phenomenon which is distinct from recurrence of Kawasaki disease.