Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1993 Dec;69(6):631-6; discussion 637-8. doi: 10.1136/adc.69.6.631

Management of Kawasaki disease in the British Isles.

R Dhillon 1, L Newton 1, P T Rudd 1, S M Hall 1
PMCID: PMC1062976  PMID: 8285773

Abstract

Kawasaki disease in the British Isles was surveyed by an active reporting scheme, based on all cases reported to the British Paediatric Surveillance Unit that were diagnosed between 1 January and 31 December 1990. The study was prompted by the need to investigate the high case fatality rate of Kawasaki disease of 2% observed in 1988. One hundred and sixty three patients were identified of whom six (3.7%) died. Forty five children (28%) suffered cardiac complications of which 39 (24%) were coronary artery abnormalities; five children were diagnosed at postmortem examination, and coronary artery abnormalities were detected by echocardiography in 34. One hundred and forty nine children (93%) had echocardiography. High thrombocytosis, leucocytosis, duration of fever, and younger age were associated with the presence of coronary artery abnormalities. Erythrocyte sedimentation rate, sex, and the number of diagnostic criteria were not. One hundred and thirty three children (87%) received aspirin. Ninety three children (61%) received intravenous gammaglobulin (IVGG). Children were more likely to receive IVGG if they had thrombocytosis or typical Kawasaki disease. The incidence of coronary artery abnormalities was found to be similar in those treated with IVGG (29%) and those untreated (20%), including those treated within 10 days of onset. This may have reflected selection of the more serious cases to receive IVGG or that Kawasaki disease in the British Isles is a different illness to that experienced elsewhere. It amy be, however, that IVGG is less effective in the treatment of British patients with Kawasaki disease than has been the experience in the United States and Japan. These observations emphasise the need for a therapeutic trial of treatment modalities for Kawasaki disease in the UK and the Republic of Ireland.

Full text

PDF
631

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Furusho K., Kamiya T., Nakano H., Kiyosawa N., Shinomiya K., Hayashidera T., Tamura T., Hirose O., Manabe Y., Yokoyama T. High-dose intravenous gammaglobulin for Kawasaki disease. Lancet. 1984 Nov 10;2(8411):1055–1058. doi: 10.1016/s0140-6736(84)91504-6. [DOI] [PubMed] [Google Scholar]
  2. Greenbaum B. H. Differences in immunoglobulin preparations for intravenous use: a comparison of six products. Am J Pediatr Hematol Oncol. 1990 Winter;12(4):490–496. doi: 10.1097/00043426-199024000-00015. [DOI] [PubMed] [Google Scholar]
  3. Hall S. M., Glickman M. The British Paediatric Surveillance Unit. Arch Dis Child. 1988 Mar;63(3):344–346. doi: 10.1136/adc.63.3.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hiew T. M., Cheng H. K. ECG abnormalities in Kawasaki disease and their value in predicting coronary artery aneurysms. Singapore Med J. 1992 Jun;33(3):262–267. [PubMed] [Google Scholar]
  5. Ichida F., Fatica N. S., Engle M. A., O'Loughlin J. E., Klein A. A., Snyder M. S., Ehlers K. H., Levin A. R. Coronary artery involvement in Kawasaki syndrome in Manhattan, New York: risk factors and role of aspirin. Pediatrics. 1987 Dec;80(6):828–835. [PubMed] [Google Scholar]
  6. Ichida F., Fatica N. S., O'Loughlin J. E., Snyder M. S., Ehlers K. H., Engle M. A. Correlation of electrocardiographic and echocardiographic changes in Kawasaki syndrome. Am Heart J. 1988 Sep;116(3):812–819. doi: 10.1016/0002-8703(88)90342-0. [DOI] [PubMed] [Google Scholar]
  7. Kato H., Inoue O., Kawasaki T., Fujiwara H., Watanabe T., Toshima H. Adult coronary artery disease probably due to childhood Kawasaki disease. Lancet. 1992 Nov 7;340(8828):1127–1129. doi: 10.1016/0140-6736(92)93152-d. [DOI] [PubMed] [Google Scholar]
  8. Koren G., Rose V., Lavi S., Rowe R. Probable efficacy of high-dose salicylates in reducing coronary involvement in Kawasaki disease. JAMA. 1985 Aug 9;254(6):767–769. [PubMed] [Google Scholar]
  9. Management of Kawasaki syndrome: a consensus statement prepared by North American participants of the Third International Kawasaki Disease Symposium, Tokyo, Japan, December, 1988. Pediatr Infect Dis J. 1989 Oct;8(10):663–667. [PubMed] [Google Scholar]
  10. Nagashima M., Matsushima M., Matsuoka H., Ogawa A., Okumura N. High-dose gammaglobulin therapy for Kawasaki disease. J Pediatr. 1987 May;110(5):710–712. doi: 10.1016/s0022-3476(87)80007-0. [DOI] [PubMed] [Google Scholar]
  11. Nakamura Y., Fujita Y., Nagai M., Yanagawa H., Imada Y., Okawa S., Kawasaki T., Kato H. Cardiac sequelae of Kawasaki disease in Japan: statistical analysis. Pediatrics. 1991 Dec;88(6):1144–1147. [PubMed] [Google Scholar]
  12. Newburger J. W., Burns J. C. Kawasaki syndrome. Cardiol Clin. 1989 May;7(2):453–465. [PubMed] [Google Scholar]
  13. Newburger J. W., Takahashi M., Beiser A. S., Burns J. C., Bastian J., Chung K. J., Colan S. D., Duffy C. E., Fulton D. R., Glode M. P. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med. 1991 Jun 6;324(23):1633–1639. doi: 10.1056/NEJM199106063242305. [DOI] [PubMed] [Google Scholar]
  14. Newburger J. W., Takahashi M., Burns J. C., Beiser A. S., Chung K. J., Duffy C. E., Glode M. P., Mason W. H., Reddy V., Sanders S. P. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med. 1986 Aug 7;315(6):341–347. doi: 10.1056/NEJM198608073150601. [DOI] [PubMed] [Google Scholar]
  15. Tizard E. J., Suzuki A., Levin M., Dillon M. J. Clinical aspects of 100 patients with Kawasaki disease. Arch Dis Child. 1991 Feb;66(2):185–188. doi: 10.1136/adc.66.2.185. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES