Abstract
Kawasaki disease is the leading cause of acquired heart disease in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. The mean annual incidence of Kawasaki disease across Canada is about 13 per 100,000 children less than 5 years of age, based on hospital discharge data from 1990 to 1995. The cause remains unknown, and the diagnosis is based on the same clinical criteria used to describe the disease over 30 years ago. However, nonspecific clinical features, evolving presentations and atypical or incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment, which occur more frequently in older children, are associated with an increased risk of coronary artery aneurysms. Hence, high diagnostic suspicion and prompt referral are required to reduce the rate of cardiac complications.
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Selected References
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- Akagi T., Rose V., Benson L. N., Newman A., Freedom R. M. Outcome of coronary artery aneurysms after Kawasaki disease. J Pediatr. 1992 Nov;121(5 Pt 1):689–694. doi: 10.1016/s0022-3476(05)81894-3. [DOI] [PubMed] [Google Scholar]
- Bronstein D. E., Besser R. E., Burns J. C. Passive surveillance for Kawasaki disease in San Diego County. Pediatr Infect Dis J. 1997 Nov;16(11):1015–1018. doi: 10.1097/00006454-199711000-00002. [DOI] [PubMed] [Google Scholar]
- Burns J. C., Shike H., Gordon J. B., Malhotra A., Schoenwetter M., Kawasaki T. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol. 1996 Jul;28(1):253–257. doi: 10.1016/0735-1097(96)00099-x. [DOI] [PubMed] [Google Scholar]
- Dajani A. S., Taubert K. A., Gerber M. A., Shulman S. T., Ferrieri P., Freed M., Takahashi M., Bierman F. Z., Karchmer A. W., Wilson W. Diagnosis and therapy of Kawasaki disease in children. Circulation. 1993 May;87(5):1776–1780. doi: 10.1161/01.cir.87.5.1776. [DOI] [PubMed] [Google Scholar]
- Dajani A. S., Taubert K. A., Takahashi M., Bierman F. Z., Freed M. D., Ferrieri P., Gerber M., Shulman S. T., Karchmer A. W., Wilson W. Guidelines for long-term management of patients with Kawasaki disease. Report from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 1994 Feb;89(2):916–922. doi: 10.1161/01.cir.89.2.916. [DOI] [PubMed] [Google Scholar]
- Davis R. L., Waller P. L., Mueller B. A., Dykewicz C. A., Schonberger L. B. Kawasaki syndrome in Washington State. Race-specific incidence rates and residential proximity to water. Arch Pediatr Adolesc Med. 1995 Jan;149(1):66–69. doi: 10.1001/archpedi.1995.02170130068016. [DOI] [PubMed] [Google Scholar]
- Dhillon R., Clarkson P., Donald A. E., Powe A. J., Nash M., Novelli V., Dillon M. J., Deanfield J. E. Endothelial dysfunction late after Kawasaki disease. Circulation. 1996 Nov 1;94(9):2103–2106. doi: 10.1161/01.cir.94.9.2103. [DOI] [PubMed] [Google Scholar]
- Kato H., Sugimura T., Akagi T., Sato N., Hashino K., Maeno Y., Kazue T., Eto G., Yamakawa R. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation. 1996 Sep 15;94(6):1379–1385. doi: 10.1161/01.cir.94.6.1379. [DOI] [PubMed] [Google Scholar]
- Kawasaki T., Kosaki F., Okawa S., Shigematsu I., Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974 Sep;54(3):271–276. [PubMed] [Google Scholar]
- Klassen T. P., Rowe P. C., Gafni A. Economic evaluation of intravenous immune globulin therapy for Kawasaki syndrome. J Pediatr. 1993 Apr;122(4):538–542. doi: 10.1016/s0022-3476(05)83532-2. [DOI] [PubMed] [Google Scholar]
- Mason W. H., Takahashi M. Kawasaki syndrome. Clin Infect Dis. 1999 Feb;28(2):169–187. doi: 10.1086/515133. [DOI] [PubMed] [Google Scholar]
- Morens D. M., Anderson L. J., Hurwitz E. S. National surveillance of Kawasaki disease. Pediatrics. 1980 Jan;65(1):21–25. [PubMed] [Google Scholar]
- 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]
- 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]
- Rowe R. D., Rose V. Kawasaki disease: Canadian update. Can Med Assoc J. 1985 Jan 1;132(1):25–28. [PMC free article] [PubMed] [Google Scholar]
- Taubert K. A., Rowley A. H., Shulman S. T. Nationwide survey of Kawasaki disease and acute rheumatic fever. J Pediatr. 1991 Aug;119(2):279–282. doi: 10.1016/s0022-3476(05)80742-5. [DOI] [PubMed] [Google Scholar]
- Taubert K. A., Rowley A. H., Shulman S. T. Seven-year national survey of Kawasaki disease and acute rheumatic fever. Pediatr Infect Dis J. 1994 Aug;13(8):704–708. doi: 10.1097/00006454-199408000-00005. [DOI] [PubMed] [Google Scholar]
- Yanagawa H., Yashiro M., Nakamura Y., Kawasaki T., Kato H. Results of 12 nationwide epidemiological incidence surveys of Kawasaki disease in Japan. Arch Pediatr Adolesc Med. 1995 Jul;149(7):779–783. doi: 10.1001/archpedi.1995.02170200069011. [DOI] [PubMed] [Google Scholar]