An Update on Reports of Atypical Presentations of Kawasaki Disease and the Recognition of IVIG Non-Responder Children

被引:6
作者
Conte, Cristiano [1 ]
Sogni, Francesco [1 ]
Rigante, Donato [2 ,3 ]
Esposito, Susanna [1 ]
机构
[1] Univ Parma, Univ Hosp, Dept Med & Surg, Pediat Clin, I-43126 Parma, Italy
[2] Fdn Policlin Univ A Gemelli IRCCS, Dept Life Sci & Publ Hlth, I-00168 Rome, Italy
[3] Univ Cattolica Sacro Cuore, I-00168 Rome, Italy
关键词
acetylsalicylic acid; coronary artery abnormality; coronary artery aneurysm; innovative biotechnologies; intravenous immunoglobulin; Kawasaki disease; personalized medicine; vascular complications; AUTOINFLAMMATORY SYNDROMES; CYTOMEGALOVIRUS-INFECTION; CORONARY ANEURYSMS; SHOCK SYNDROME; ACUTE-PHASE; INVOLVEMENT; MULTICENTER; THERAPY; HEART; HEMOPHAGOCYTOSIS;
D O I
10.3390/diagnostics13081441
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Kawasaki disease (KD) is an acute vasculitis with an intrinsic risk of severe involvement of coronary arteries. The worldwide spread of KD and the importance of early diagnosis for preventing cardiovascular complications have ascertained the need for updating guidelines for prompt disease recognition and treatment efficacy assessment. All KD patients who comply with the definition of classic or atypical disease should be treated with intravenous immunoglobulin (IVIG) soon after diagnosis. The objective of our narrative review was to analyze the medical literature about case reports with atypical KD in relation to diagnosis and potential identification of predictors of non-responsiveness to IVIG. Our analysis has shown that the seminal challenge in KD management is the timeliness of diagnosis, although both extreme variability and transience of clinical manifestations make this goal difficult. A non-negligible percentage of patients, especially in the first 6 months of life, might have atypical manifestations of KD, whose painstaking differential diagnosis may be tricky. Many attempts to develop universal scoring systems and detect children at higher risk of IVIG resistance have been rather unsuccessful. Additionally, KD may show different evolutions according to unraveled demographic, genetic, or epigenetic factors. Further research is needed to elucidate all open questions about KD and clarify the long-term outcome of its potential complications.
引用
收藏
页数:15
相关论文
共 99 条
[61]   Etanercept With IVIg for Acute Kawasaki Disease: A Randomized Controlled Trial [J].
Portman, Michael A. ;
Dahdah, Nagib S. ;
Slee, April ;
Olson, Aaron K. ;
Choueiter, Nadine F. ;
Soriano, Brian D. ;
Buddhe, Sujatha ;
Altman, Carolyn A. ;
Del Toro, Kamill ;
Kourtidou, Soultana ;
Wisotzkey, Bethany ;
Bruce, Margaret ;
Cox, Jennifer ;
Williams, Richard ;
Reeder, Jamie ;
Kirkpatrick, Edward ;
Malloy, Marsha ;
Krolikowslki, Mary ;
Briere, Julie ;
Breault, Fabiola ;
Rajan, Sujatha ;
Mensch, Deborah ;
Stellato, Nancy ;
Rubin, Lorry ;
Sood, Sunil ;
Leibowitz, Jill ;
Shah, Rita ;
Soma, Vijaya ;
Cooper, Rubin ;
DeMers, Christine ;
Sexson-Tejtel, Sara K. ;
Griffin, Debra ;
Shittu, Teniola ;
Munjal, Iona ;
Balem, Kelly Ann ;
Imundo, Lisa ;
Isgro, Josephine ;
Ferris, Anne ;
Slee, April .
PEDIATRICS, 2019, 143 (06)
[62]   Pancreatitis and atypical Kawasaki disease [J].
Prokic, Dragan ;
Ristic, Goran ;
Paunovic, Zoran ;
Pasic, Srdjan .
PEDIATRIC RHEUMATOLOGY, 2010, 8
[63]   Kawasaki Disease and Coronary Artery Involvement: A Narrative Review [J].
Rajasekaran, Kruthiga ;
Duraiyarasan, Shrimahitha ;
Adefuye, Mayowa ;
Manjunatha, Nisha ;
Ganduri, Vinutna .
CUREUS JOURNAL OF MEDICAL SCIENCE, 2022, 14 (08)
[64]   Pulmonary Presentation of Atypical Kawasaki Disease [J].
Ramamoorthy, Jaikumar Govindaswamy ;
Anantharaj, Avinash .
INDIAN JOURNAL OF PEDIATRICS, 2021, 88 (04) :413-414
[65]   A case report of atypical Kawasaki disease presented with severe elevated transaminases and literature review [J].
Ren, Yifan ;
Zhang, Chuanxin ;
Xu, Xiaoqin ;
Yin, Yu .
BMC INFECTIOUS DISEASES, 2021, 21 (01)
[66]   Catastrophic Kawasaki disease unresponsive to IVIG in a 3-month-old infant: a diagnostic and therapeutic challenge [J].
Ribeiro de Magalhaes, Cristina Medeiros ;
de Magalhaes Alves, Natalia Ribeiro ;
de Melo, Adriana Valenca ;
da Silveira Junior, Clodoaldo Abreu ;
de Medeiros Nobrega, Yanna Karla ;
Gandolfi, Lenora ;
Pratesi, Riccardo .
PEDIATRIC RHEUMATOLOGY, 2012, 10
[67]  
Rigante D, 2010, EUR REV MED PHARMACO, V14, P1
[68]   Kawasaki Disease as the Immune-Mediated Echo of a Viral Infection [J].
Rigante, Donato .
MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES, 2020, 12
[69]   A systematic approach to autoinflammatory syndromes: a spelling booklet for the beginner [J].
Rigante, Donato .
EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2017, 13 (06) :571-597
[70]   Critical Overview of the Risk Scoring Systems to Predict Non-Responsiveness to Intravenous Immunoglobulin in Kawasaki Syndrome [J].
Rigante, Donato ;
Andreozzi, Laura ;
Fastiggi, Michele ;
Bracci, Benedetta ;
Natale, Marco Francesco ;
Esposito, Susanna .
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2016, 17 (03)