A Comprehensive Update on Kawasaki Disease Vasculitis and Myocarditis

@article{Soni2020ACU,
  title={A Comprehensive Update on Kawasaki Disease Vasculitis and Myocarditis},
  author={Priya R Soni and Magali Noval Rivas and Moshe Arditi},
  journal={Current Rheumatology Reports},
  year={2020},
  volume={22}
}
Kawasaki disease (KD) is a childhood systemic vasculitis of unknown etiology that causes coronary artery aneurysms (CAA), and if left undiagnosed can result in long-term cardiovascular complications and adult cardiac disease. Up to 20% of KD children fail to respond to IVIG, the mainstay of therapy, highlighting the need for novel therapeutic strategies. Here we review the latest findings in the field regarding specific etiology, genetic associations, and advancements in treatment strategies to… Expand
Early anti IL-1 treatment replaces steroids in refractory Kawasaki disease: clinical experience from two case reports
TLDR
This work reports two cases of children, diagnosed with KD, nonresponsive to two doses of intravenous immunoglobulins, successfully treated with anakinra, without a prior use of steroids, and encourages an earlier recourse to ANA in patients with refractory KD. Expand
Kawasaki Disease, Multisystem Inflammatory Syndrome in Children: Antibody-Induced Mast Cell Activation Hypothesis
TLDR
The mast cell hypothesis that increased histamine levels are inducing contraction of effector cells with impeded blood flow through cardiac capillaries is extended and may result in increased coronary artery blood pressure leading to aneurysms in some patients. Expand
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TLDR
There is very little understanding of what triggers the MIS-C, which necessitates a rigorous mapping of the disease and associated risk elements for better disease management and navigating through this crisis. Expand
Is there an association between intravenous immunoglobulin resistance and coronary artery lesion in Kawasaki disease?—Current evidence based on a meta-analysis
TLDR
This is the first meta-analysis to reveal the incidence of CAL was associated with IVIG resistance in KD patients, and well-designed studies with uniform criteria are needed to evaluate the occurrence of CAL in IVIG resistant patients. Expand
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TLDR
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Similarities and Differences Between COVID-19-Related Multisystem Inflammatory Syndrome in Children and Kawasaki Disease
TLDR
A narrative review is to discuss the differences between MIS-C and KD with the aim of increasing pediatricians' awareness of this new condition and guide them in the process of differential diagnosis. Expand
Clinical manifestations of Kawasaki disease in different age groups: retrospective data from Southwest China
TLDR
Cough, diarrhea, vomiting, and sterile pyuria were very common in infant KD patients less than 1 year old, and should be noted in patients with suspected KD for earlier diagnosis and timely treatments. Expand
Increased concentrations of growth differentiation factor-15 in children with Kawasaki disease.
  • Gang Li, Ting Wang, +7 authors B. Liu
  • Medicine
  • Clinica chimica acta; international journal of clinical chemistry
  • 2020
TLDR
Serum of GDF-15 concentrations was significantly increased in acute Kawasaki disease patients, especially in KD with CALs and no response KD, indicating that G DF-15 could sever as an independent predictor for CALs, while it was not inferior to the combination of CRP and ESR for predicting CALs. Expand
MicroRNA-223 Regulates the Development of Cardiovascular Lesions in LCWE-Induced Murine Kawasaki Disease Vasculitis by Repressing the NLRP3 Inflammasome
TLDR
The data reveal a previously unappreciated role of miR-223 in regulating innate immune responses and in limiting KD vasculitis and its cardiovascular lesions by constraining the NLRP3 inflammasome and the IL-1β pathway. Expand
Autophagy-mitophagy induction attenuates cardiovascular inflammation in a murine model of Kawasaki disease vasculitis
TLDR
It is demonstrated that impaired autophagy/mitophagy and ROS-dependent damage exacerbate the development of murine KD vasculitis and this pathway can be efficiently targeted to reduce disease severity. Expand
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References

SHOWING 1-10 OF 130 REFERENCES
Pathogenesis and management of Kawasaki disease
TLDR
Current management of acute Kawasaki disease is based upon prospective, multicenter treatment trials of intravenous immunoglobulin (IVIG) with high-dose aspirin, and new research has led to identification of viral-like cytoplasmic inclusion bodies in acute KD tissues, which could lead to identified of the elusive etiologic agent. Expand
Dissecting Kawasaki disease: a state-of-the-art review
TLDR
As increasing numbers of KD patients are reaching adulthood, increasing information is available about the long-term consequences of coronary artery damage and broader cardiovascular risk. Expand
A child with resistant Kawasaki disease successfully treated with anakinra: a case report
TLDR
This is the first report of the utility of IL-1RA in refractory KD without coronary impairment and, after becoming resistant to first and second line treatments, anakinra proved to be an effective treatment. Expand
Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association
TLDR
These recommendations provide updated and best evidence-based guidance to healthcare providers who diagnose and manage Kawasaki disease, but clinical decision making should be individualized to specific patient circumstances. Expand
When children with Kawasaki disease grow up: Myocardial and vascular complications in adulthood.
TLDR
The current literature is reviewed that may be helpful to clinicians who care for adults who experienced KD in childhood and there are no established guidelines for the evaluation and treatment of adult patients who have had KD. Expand
Myocarditis and Kawasaki disease
TLDR
It is noteworthy that myocarditis associated with KD can occur in absence of coronary artery abnormalities, and can result in long‐term sequelae. Expand
Kawasaki Disease
TLDR
The current understanding of clinical presentations, pathophysiological concepts, disease-associated complications, and available pharmaceutical treatment is provided and discussed in the context of available literature. Expand
Rationale and study design for a phase I/IIa trial of anakinra in children with Kawasaki disease and early coronary artery abnormalities (the ANAKID trial).
TLDR
The safety and tolerability of blocking both IL-1α and Il-1β by anakinra will be evaluated as a strategy to prevent or attenuate coronary artery damage in infants and children with acute KD. Expand
Finding the cause of Kawasaki disease: a pediatric infectious diseases research priority.
  • A. Rowley
  • Medicine
  • The Journal of infectious diseases
  • 2006
though intravenous gammaglobulin (IVIG) with aspirin is effective therapy for most children with acute KD, its mechanism of action is unknown, and some children do not respond. In the present era ofExpand
A child with severe relapsing Kawasaki disease rescued by IL-1 receptor blockade and extracorporeal membrane oxygenation
TLDR
It is reported, for the first time, the beneficial use of an interleukin-1 receptor antagonist (IL-1RA) in relapsing KD, which is associated with the development of coronary artery aneurysms in 15–25% of untreated cases. Expand
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