Acute Phase Treatment for Infants Younger Than 1 Year of Age with Kawasaki Disease: A Single Center Retrospective Study

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, causing coronavirus disease 2019 (COVID-19), has rapidly spread worldwide. Recently, cases of Kawasaki-like syndrome associated with COVID-19 (MIS‐C/PIMS) have been reported in the USA and Europe. However, the clinical features of Kawasaki disease (KD) in Japan during the SARS-CoV-2 epidemic remain unclear. Therefore, this retrospective study aimed to evaluate the clinical features of KD in our department during the year of the COVID-19 pandemic (2020). Data were obtained from 45 KD patients who underwent acute-phase treatment from January 2018 to December 2020. The patients were divided into three groups: (1) 2018 group, in which 18 patients receiving acute-phase treatment during 2018; (2) 2019 group, in which 17 patients receiving acute-phase treatment during 2019; and (3) 2020 group, in which 10 patients receiving acute-phase treatment during 2020. The comparison of the clinical findings, treatments, and outcomes among the three groups (2018 vs. 2019 vs. 2020 group) revealed a significant difference in the rate of the male gender (72.2% vs. 41.2% vs. 10.0%, P < 0.010), recurrence (0.0% vs. 0.0% vs. 25.0%, P = 0.015), and coronary artery lesions (16.7% vs. 0.0% vs. 0.0%, P = 0.044). No patients required ventilation assistance or inotropic agents and met the diagnostic criteria of MIS‐C/PIMS. Further studies are warranted to elucidate the clinical features of KD during the SARS-CoV-2 epidemic.

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Acute-phase Treatment and Prevention of Large Coronary Artery Lesions in Kawasaki Disease

10.9734/bpi/mono/978-93-5547-267-0 ◽

2021 ◽

Author(s):

Toshimasa Nakada

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Acute Phase ◽

Coronary Artery Lesions ◽

Treatment And Prevention ◽

Large Coronary Artery ◽

Acute Phase Treatment

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Retrospective study of the course, treatment and long-term follow-up of Kawasaki disease: a single-center experience from Poland

Rheumatology International ◽

10.1007/s00296-019-04286-9 ◽

2019 ◽

Vol 39 (6) ◽

pp. 1069-1076 ◽

Cited By ~ 1

Author(s):

Aleksandra Stasiak ◽

Elżbieta Smolewska

Keyword(s):

Retrospective Study ◽

Kawasaki Disease ◽

Single Center ◽

Single Center Experience ◽

Long Term Follow Up

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Useful predictors of Kawasaki disease without complications before initial acute-phase treatment

GSC Advanced Research and Reviews ◽

10.30574/gscarr.2021.7.3.0122 ◽

2021 ◽

Vol 7 (3) ◽

pp. 018-027

Author(s):

Toshimasa Nakada

Keyword(s):

Kawasaki Disease ◽

Acute Phase ◽

Systemic Vasculitis ◽

Rescue Therapy ◽

Ivig Therapy ◽

Therapy Resistance ◽

Albumin Ratio ◽

Reactive Protein ◽

Ivig Resistance ◽

Acute Phase Treatment

Kawasaki disease (KD) is an acute febrile systemic vasculitis that primarily affects children younger than 5 years, with coronary artery lesions (CALs) as its severe complications. Intravenous immunoglobulin (IVIG) therapy resistance has been implicated in CAL development, and its known predictors are as follows: Egami score, Kobayashi score, C-reactive protein (CRP), albumin, CRP-to-albumin ratio, and neutrophil-to-lymphocyte ratio (NLR). However, the most useful predictor for IVIG resistance in patients with KD without complications before initial acute-phase treatment remains unclear. Therefore, this study aimed to determine the most useful predictor for IVIG resistance in such patients. This retrospective study included data from 202 patients with KD who underwent acute-phase treatment from January 2009 to March 2021. Among 46 IVIG-resistant patients, 22 patients required rescue therapy (rescued patients), while the remaining 24 received no rescue therapy for resistance and had no CALs. Among the 6 indices, NLR had the highest sensitivity and specificity for the detection of all IVIG-resistant patients and rescued patients (0.724 and 0.728, respectively), and logistic regression analysis showed that the NLR was the sole independent predictor both for the IVIG-resistant patients and for the rescued patients (P < 0.001 and = 0.002, Odds ratio = 5.797 and 5.814, 95% confidence interval = 2.687–12.504 and 1.954–17.299, respectively). NLR was the useful predictor for all IVIG-resistant patients and rescued patients among those with KD without complications before initial acute-phase treatment.

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Acute Phase Treatment and Medium-Term Outcomes in Kawasaki Disease

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2020.2.4.419 ◽

2020 ◽

Vol 2 (4) ◽

Author(s):

Toshimasa Nakada

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Acute Phase ◽

Coronary Artery Stenosis ◽

Ivig Therapy ◽

Initial Therapy ◽

Artery Stenosis ◽

Cardiac Events ◽

Medium Term ◽

Acute Phase Treatment

An acute phase treatment for prevention of coronary artery stenosis caused by Kawasaki disease (KD) has not been established. The objective of this study was to clarify the medium-term outcomes of patients who received acute phase treatment in our department. This retrospective study included data from 214 patients with KD who received acute phase treatment from January 2009 to May 2020. A total of 196 (92.1%) received an initial single dose of intravenous immunoglobulin (IVIG) therapy. One patient with status epilepticus at presentation received initial IVIG plus steroid therapy. A total of 17 patients did not receive IVIG. The rate of coronary artery lesions (CALs) 1 month and 1 year after KD onset were 1.9% and 0.9%, respectively. Two patients had CAL 1 year after KD onset. However, no patients had coronary artery stenosis. One patient with a right giant CAL had a medium CAL before initial therapy. During a median follow-up period of 3 years and 4 months, no patients had cardiac events that required therapy.

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Cardiovascular outcomes following Kawasaki disease in Moscow, Russia: A single center experience

Global Cardiology Science and Practice ◽

10.21542/gcsp.2017.23 ◽

2018 ◽

Vol 2017 (3) ◽

Cited By ~ 2

Author(s):

Galina Lyskina ◽

Olga Bockeria ◽

Olga Shirinsky ◽

Alena Torbyak ◽

Anna Leontieva ◽

...

Keyword(s):

Retrospective Study ◽

Coronary Artery ◽

Kawasaki Disease ◽

Moscow Region ◽

Single Center ◽

Coronary Artery Aneurysms ◽

Delayed Treatment ◽

Giant Aneurysms ◽

Single Center Experience ◽

Over Time

Background: Awareness of Kawasaki disease (KD) is emerging in Russia but the diagnosis is still often missed. Methods: This is a retrospective study of 303 children with KD who received care at a single center in Moscow over the period from 2004 to 2016. Results: Overall, coronary artery aneurysms were documented in 91 (30,0%) of 303 patients and transient ectasia in 40 (13,2%). Intracoronary thrombi were found in 12 of 15 patients with giant aneurysms and in 3 patients with medium-sized aneurysms. Conclusion: The patients with KD in the Moscow region had typical features of the disease described in the literature but the proportion of patients with coronary artery aneurysms was higher than reported from other countries. We assume that this is due to delayed treatment, which has gradually improved over time. Increased awareness of KD in Russia is critical to ensure timely diagnosis and treatment.

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