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Children
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Kawasaki Disease in Children and Adolescents
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Kawasaki Disease in Children and Adolescents

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (1 December 2018) | Viewed by 21768

Special Issue Editor

Prof. Dr. Robert Tulloh

E-Mail Website
Guest Editor
Bristol Royal Hospital for Children, Bristol Heart Institute and University of Bristol, UK
Interests: congenital cardiology; pulmonary hypertension; Kawasaki disease; education; respiratory syncitial virus

Special Issue Information

Dear Colleagues,

Kawasaki disease was once a rare diagnosis, but now it is increasingly common. The recent British Paediatric Surveillance Unit study showed that there were 19% of children with coronary artery aneurysms as a consequence. It also showed that the incidence is increasing and globally, we find that the incidence is doubling every 10 years. These may have life-long effect on the developing child. Those most likely to develop such aneurysms live in rural areas, and have fewest of the associated clinical features, are diagnosed late and treated late as a consequence.

Sadly, many clinicians in the Western world believe that this condition is too rare to be seen on the wards. We hope that this Special Issue will highlight the areas of concern, those where there is lack of knowledge and those where there is more work to be undertaken, raising awareness as a consequence for the benefit of future children.

Prof. Dr. Robert Tulloh
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Kawasaki Disease
  • Coronary artery aneurysm
  • Intravenous immunoglobulin
  • Infants
  • Adolescents
  • Coronary artery disease

Published Papers (4 papers)

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Review

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7 pages, 645 KiB  
Review
Cardiac Catheterization in Assessment and Treatment of Kawasaki Disease in Children and Adolescents
by Hitesh Agrawal and Athar M. Qureshi
Children 2019, 6(2), 32; https://doi.org/10.3390/children6020032 - 21 Feb 2019
Cited by 2 | Viewed by 5990
Abstract
Cardiac catheterization has become a promising tool to assess and treat coronary artery lesions in patients with Kawasaki disease. Significant coronary artery lesions can now be treated via transcatheter route even in small children. Further development and miniaturization of this technology will help [...] Read more.
Cardiac catheterization has become a promising tool to assess and treat coronary artery lesions in patients with Kawasaki disease. Significant coronary artery lesions can now be treated via transcatheter route even in small children. Further development and miniaturization of this technology will help to promote widespread use to the benefit of small children suffering from coronary artery disease. The role of diagnostic and interventional coronary artery procedures in children and adolescents are discussed in this article. Full article
(This article belongs to the Special Issue Kawasaki Disease in Children and Adolescents)
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12 pages, 2321 KiB  
Review
Significance of Coronary Revascularization for Coronary-Artery Obstructive Lesions Due to Kawasaki Disease
by Soichiro Kitamura and Etsuko Tsuda
Children 2019, 6(2), 16; https://doi.org/10.3390/children6020016 - 29 Jan 2019
Cited by 14 | Viewed by 5353
Abstract
As an acquired ischemic heart disease in childhood, coronary-artery disease caused by Kawasaki disease (KD) has been known worldwide since the mid-1970s. KD patients who develop coronary-artery obstructive disease often need revascularization some time in their life. Coronary-artery revascularization for KD coronary lesions [...] Read more.
As an acquired ischemic heart disease in childhood, coronary-artery disease caused by Kawasaki disease (KD) has been known worldwide since the mid-1970s. KD patients who develop coronary-artery obstructive disease often need revascularization some time in their life. Coronary-artery revascularization for KD coronary lesions can be done with the surgical coronary-artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures. However, the characteristics of coronary-arterial lesions caused by KD significantly differ from atherosclerotic coronary disease in adults. Therefore, it is much more difficult to determine the optimal time and selection of a coronary-artery revascularization procedure for KD sequelae. CABG using the internal thoracic artery has been accepted as a very useful and beneficial procedure since the mid-1980s, even in small children. Although the use of PCI in the late period can be effective in some adolescent and adult patients, the small vessel size and severe coronary-artery calcification are often limiting factors for its use in children. Therefore, CABG is a better approach for severe leftanterior descending artery and multiple-vessel disease in children and adolescents with KD coronary sequelae. Good coronary revascularization can improve the long-term outcomes of patients with severe KD complications. Full article
(This article belongs to the Special Issue Kawasaki Disease in Children and Adolescents)
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6 pages, 197 KiB  
Review
A Decade of NT-proBNP in Acute Kawasaki Disease, from Physiological Response to Clinical Relevance
by Audrey Dionne and Nagib Dahdah
Children 2018, 5(10), 141; https://doi.org/10.3390/children5100141 - 12 Oct 2018
Cited by 23 | Viewed by 5327
Abstract
Kawasaki disease (KD) is an inflammatory febrile illness of early childhood and the primary cause of acquired heart disease during childhood. Coronary artery aneurysms (CAA) are a serious complication of KD, leading to ischemic heart disease, myocardial infarction, and sudden cardiac death. Timely [...] Read more.
Kawasaki disease (KD) is an inflammatory febrile illness of early childhood and the primary cause of acquired heart disease during childhood. Coronary artery aneurysms (CAA) are a serious complication of KD, leading to ischemic heart disease, myocardial infarction, and sudden cardiac death. Timely diagnosis in the first ten days of fever is crucial to reduce the risk of coronary artery complications. Nitrogen-terminal B-type natriuretic peptide (NT-proBNP), originally used for the management of adults with heart disease, was shown to be useful in the diagnosis and management of patients with KD. NT-proBNP is released by cardiomyocytes in response to mechanical factors such as the dilation of cardiac chambers, and to pro-inflammatory cytokines. The utility of NT-proBNP as a biological marker in KD is based on the universal myocardial inflammatory component early in the course of the disease. Patients with KD have higher NT-proBNP at the time of diagnosis than febrile controls, with a pooled sensitivity of 89% (95% confidence interval 78–95), and a specificity of 72% (95% confidence interval 58–82). The positive likelihood ratio is 3.2:1 (95% confidence interval 2.1–4.8). Moreover, patients with resistance to intravenous immunoglobulin treatment and CAA were found to have higher levels of NT-proBNP, suggesting a prognostic role. Nevertheless, the non-specificity of NT-proBNP to KD limits its use as a stand-alone test. In this light, a tentative associative retrospective diagnostic algorithm was highly reliable for including all cases at risk of CAA, which warrants further prospective studies for a better diagnostic index of suspicion and risk stratification of patients. Full article
(This article belongs to the Special Issue Kawasaki Disease in Children and Adolescents)

Other

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5 pages, 478 KiB  
Case Report
Recurrent Kawasaki Disease: A Case Report of Three Separate Episodes at >4-Year Intervals
by Nikita Goswami, Katherine Marzan, Elizabeth De Oliveira, Sharon Wagner-Lees and Jacqueline Szmuszkovicz
Children 2018, 5(11), 155; https://doi.org/10.3390/children5110155 - 21 Nov 2018
Cited by 5 | Viewed by 4588
Abstract
Kawasaki disease (KD) is a self-limited systemic vasculitis, most often occurring in children 1–5 years old. It has a 2% recurrence rate and is associated with coronary aneurysms (CA), which can develop within two weeks of onset. A 25% increased risk is noted [...] Read more.
Kawasaki disease (KD) is a self-limited systemic vasculitis, most often occurring in children 1–5 years old. It has a 2% recurrence rate and is associated with coronary aneurysms (CA), which can develop within two weeks of onset. A 25% increased risk is noted in patients who are recalcitrant to treatment. We describe a patient with recurrence of KD three times, approximately four years apart. A 10-year-old female with two previous episodes of KD, at 11 months and five years of age), in which she met five out of five criteria for KD and had no coronary involvement, presented with 15 days of fever, conjunctivitis and mucocutaneous changes. Infectious work-up was negative, and she was diagnosed with incomplete KD meeting three out of five criteria. An echocardiogram (ECHO) on day 12 revealed dilation of the right coronary artery (RCA) and left coronary artery (LCA). Treatment with intravenous immunoglobulin (IVIG) and high-dose aspirin was started at an outside hospital. After transfer, serial ECHOs showed evolving coronary aneurysms, left anterior descending (LAD) z-score + 8.2 and RCA z-score + 4.0. She received 10 mg/kg infliximab (day 18) and began clopidogrel. A cardiac MRI (day 20) demonstrated progression of the LAD aneurysm, with a z-score + 13, and warfarin was started. To our knowledge, this is the first report of recurrent KD occurring three times at ~5 year intervals. Full article
(This article belongs to the Special Issue Kawasaki Disease in Children and Adolescents)
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