Advertisement

The Indian Journal of Pediatrics

, Volume 76, Issue 1, pp 71–76 | Cite as

Kawasaki Disease update

  • Jane C. BurnsEmail author
Symposium on Advances in Cardiology — I

Abstract

Kawasaki Disease is rapidly becoming the most common cause of acquired heart disease in children in both the developed and developing world. Its etiology remains a mystery but important progress has been made in characterizing the features of the arterial wall and myocardial pathology and long-term clinical consequences. New treatments aimed at modifying the host immune response are currently under study. The genetic influence on susceptibility and disease outcome is an area of active research.

Key Words

Kawasaki disease Vasculitis Coronary artery aneurysms Myocardial infraction 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kawasaki T. [Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children]. Arerugi 1967; 16: 178–222.PubMedGoogle Scholar
  2. 2.
    Burns JC. Commentary: translation of Dr. Tomisaku Kawasaki’s original report of fifty patients in 1967. Pediatr Infect Dis J 2002; 21: 993–995.CrossRefPubMedGoogle Scholar
  3. 3.
    Burns JC, Kushner HI, Bastian JF, Shike H, Shimizu C, Matsubara T et al. Kawasaki disease: A brief history. Pediatrics. 2000; 106: E27.CrossRefPubMedGoogle Scholar
  4. 4.
    Kato H, Sugimura T, Akagi T, Sato N, Hashino K, Maeno Y et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996; 94: 1379–1385.PubMedGoogle Scholar
  5. 5.
    Capannari TE, Daniels SR, Meyer RA, Schwartz DC, Kaplan S. Sensitivity, specificity and predictive value of two-dimensional echocardiography in detecting coronary artery aneurysms in patients with Kawasaki disease. J Am Coll Cardiol 1986; 7: 355–360.CrossRefPubMedGoogle Scholar
  6. 6.
    Fujiwara H, Hamashima Y. Pathology of the heart in Kawasaki disease. Pediatrics 1978; 61: 100–107.PubMedGoogle Scholar
  7. 7.
    de Zorzi A, Colan SD, Gauvreau K, Baker AL, Sundel RP, Newburger JW. Coronary artery dimensions may be misclassified as normal in Kawasaki disease. J Pediatr 1998; 133: 254–258.CrossRefPubMedGoogle Scholar
  8. 8.
    Newburger JW, Takahashi M, Beiser AS, Burns JC, Bastian J, Chung KJ et al. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. New Eng J Med 1991; 324: 1633–1639.CrossRefPubMedGoogle Scholar
  9. 9.
    Tsuda E, Matsuo M, Naito H, Noguchi T, Nonogi H, Echigo S. Clinical features in adults with coronary arterial lesions caused by presumed Kawasaki disease. Cardiol Young 2007; 17: 84–89.CrossRefPubMedGoogle Scholar
  10. 10.
    Tsuda E, Hanatani A, Kurosaki K, Naito H, Echigo S. Two young adults who had acute coronary syndrome after regression of coronary aneurysms caused by Kawasaki disease in infancy. Pediatr Cardiol 2006; 27: 372–375.CrossRefPubMedGoogle Scholar
  11. 11.
    Nakada T. Ventricular arrhythmia and possible myocardial ischemia in late stage Kawasaki disease: patient with a normal coronary arteriogram. Acta Paediatr Jpn 1996; 38: 365–369.PubMedGoogle Scholar
  12. 12.
    Yagi S, Tsuda E, Shimizu W, Kurita T, Seguchi O, Nonogi H et al. Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease. Circ J 2005; 69: 870–874.CrossRefPubMedGoogle Scholar
  13. 13.
    Taneja A. U. S. Mucocutaneous lymph node syndrome. Indian Pediatrics 1977; 14: 927–931.PubMedGoogle Scholar
  14. 14.
    Kushner HI, Bastian JF, Turner CL, Burns JC. The two emergencies of Kawasaki syndrome and the implications for the developing world. Pediatr Infect Dis J 2008; 27: 377–383.CrossRefPubMedGoogle Scholar
  15. 15.
    Kushner HI, Macnee R, Burns JC. Impressions of Kawasaki syndrome in India. Indian Pediatr 2006; 43: 939–942.PubMedGoogle Scholar
  16. 16.
    Krishnakumar P, Mathews L. Kawasaki disease is not rare in India. Indian J Pediatr 2006; 73: 544–545.CrossRefPubMedGoogle Scholar
  17. 17.
    Nakamura Y, Yashiro M, Uehara R, Oki I, Watanabe M, Yanagawa H. Epidemiologic Features of Kawasaki Disease in Japan: Results from the Nationwide Survey in 2005–2006. J Epidemiol 2008; 18: 167–172CrossRefPubMedGoogle Scholar
  18. 18.
    Imbach P, Barandun S, d’Apuzzo V, Baumgartner C, Hirt A, Morell A et al. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet 1981; 1: 1228–1231.CrossRefPubMedGoogle Scholar
  19. 19.
    Furusho K, Kamiya T, Nakano H, Kiyosawa N, Shinomiya K, Hayashidera T et al. High-dose intravenous gammaglobulin for Kawasaki disease. Lancet 1984; 2: 1055–1058.CrossRefPubMedGoogle Scholar
  20. 20.
    Newburger JW, Takahashi M, Burns JC, Beiser AS, Chung KJ, Duffy CE et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. New Eng J Med 1986; 315: 341–347.CrossRefPubMedGoogle Scholar
  21. 21.
    Morikawa Y, Ohashi Y, Harada K, Asai T, Okawa S, Nagashima M et al. A multicenter, randomized, controlled trial of intravenous gamma globulin therapy in children with acute Kawasaki disease. Acta Paediatr Jpn 1994; 36: 347–354.PubMedGoogle Scholar
  22. 22.
    Sundel RP, Burns JC, Baker A, Beiser AS, Newburger JW. Gamma globulin re-treatment in Kawasaki disease. J Pediatr 1993; 123: 657–659.CrossRefPubMedGoogle Scholar
  23. 23.
    Burns JC, Capparelli EV, Brown JA, Newburger JW, Glode MP. Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J 1998; 17: 1144–1148.CrossRefPubMedGoogle Scholar
  24. 24.
    Tsai MH, Huang YC, Yen MH, Li CC, Chiu CH, Lin PY et al. Clinical responses of patients with Kawasaki disease to different brands of intravenous immunoglobulin. J Pediatr 2006; 148: 38–43.CrossRefPubMedGoogle Scholar
  25. 25.
    Uehara R, Yashiro M, Oki I, Nakamura Y, Yanagawa H. Retreatment regimens for acute stage of Kawasaki disease patients who failed to respond to initial intravenous immunoglobulin therapy: Analysis from the 17th nationwide survey. Pediatr Int 2007; 49: 427–430.CrossRefPubMedGoogle Scholar
  26. 26.
    Durongpisitkul K, Sangtawesin C, Khongphatthanayopthin A, Panamonta M, Sopontammarak S, Sittiwangkul R et al. Epidemiologic study of Kawasaki disease and cases resistant to IVIG therapy in Thailand. Asian Pac J Allergy Immunol 2006; 24: 27–32.PubMedGoogle Scholar
  27. 27.
    Durongpisitkul K, Soongswang J, Laohaprasitiporn D, Nana A, Prachuabmoh C, Kangkagate C. Immunoglobulin failure and retreatment in Kawasaki disease. Pediatr Cardiol 2003; 24: 145–148.CrossRefPubMedGoogle Scholar
  28. 28.
    Kashef S, Safari M, Amin R. Initial intravenous gammaglobulin treatment failure in Iranian children with Kawasaki disease. Kaohsiung J Med Sciences 2005; 21: 401–404.CrossRefGoogle Scholar
  29. 29.
    Burns JC, Best BM, Mejias A, Mahony L, Fixler DE, Jafri HS et al. Infliximab Treatment of Intravenous Immunoglobulin-Resistant Kawasaki Disease. J Pediatr 2008; 153: 833–838.CrossRefPubMedGoogle Scholar
  30. 30.
    Tremoulet AH, Best BM, Song S, Wang S, Corinaldesi E, Eichenfield JR et al. Resistance to intravenous immunoglobulin in children with Kawasaki disease. J Pediatr 2008; 153: 117–121.CrossRefPubMedGoogle Scholar
  31. 31.
    Egami K, Muta H, Ishii M, Suda K, Sugahara Y, Iemura M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease. J Pediatr 2006; 149: 237–240.CrossRefPubMedGoogle Scholar
  32. 32.
    Kobayashi T, Inoue Y, Takeuchi K, Okada Y, Tamura K, Tomomasa T et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation 2006; 113: 2606–2612.CrossRefPubMedGoogle Scholar
  33. 33.
    Holman RC, Curns AT, Belay ED, Steiner CA, Effler PV, Yorita KL et al. Kawasaki syndrome in Hawaii. Pediatr Infect Dis J 2005; 24: 429–433.CrossRefPubMedGoogle Scholar
  34. 34.
    Fujita Y, Nakamura Y, Sakata K, Hara N, Kobayashi M, Nagai M et al. Kawasaki disease in families. Pediatrics 1989; 84: 666–669.PubMedGoogle Scholar
  35. 35.
    Dergun M, Kao A, Hauger SB, Newburger JW, Burns JC. Familial occurrence of Kawasaki syndrome in North America. Arch Pediatr Adolesc Med 2005; 159: 876–881.CrossRefPubMedGoogle Scholar
  36. 36.
    Burns JC, Shimizu C, Shike H, Newburger JW, Sundel RP, Baker AL et al. Family-based association analysis implicates IL-4 in susceptibility to Kawasaki disease. Genes Immun 2005; 6: 438–444.CrossRefPubMedGoogle Scholar
  37. 37.
    Onouchi Y, Tamari M, Takahashi A, Tsunoda T, Yashiro M, Nakamura Y et al. A genomewide linkage analysis of Kawasaki disease: evidence for linkage to chromosome 12. J Hum Genet 2007; 52: 179–190.CrossRefPubMedGoogle Scholar
  38. 38.
    Onouchi Y, Gunji T, Burns JC, Shimizu C, Newburger JW, Yashiro M et al. ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms. Nature Genetics 2008; 40: 35–42.CrossRefPubMedGoogle Scholar
  39. 39.
    Tsuda E, Kamiya T, Kimura K, Ono Y, Echigo S. Coronary artery dilatation exceeding 4.0 mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol 2002; 23: 9–14.CrossRefPubMedGoogle Scholar
  40. 40.
    Tsuda E, Kamiya T, Ono Y, Kimura K, Echigo S. Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart 2005; 91: 177–182.CrossRefPubMedGoogle Scholar
  41. 41.
    Tsuda E, Kamiya T, Ono Y, Kimura K, Kurosaki K, Echigo S. Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease. Pediatr Cardiol 2005; 26: 73–79.CrossRefPubMedGoogle Scholar
  42. 42.
    Tsuda E, Yasuda T, Naito H. Vasospastic angina in Kawasaki disease. J Cardiology 2008; 51: 65–69.CrossRefGoogle Scholar
  43. 43.
    Tsuda E, Arakaki Y, Shimizu T, Sakaguchi H, Yoshimura S, Yazaki S et al. Changes in causes of sudden deaths by decade in patients with coronary arterial lesions due to Kawasaki disease. Cardiol Young 2005; 15: 481–488.CrossRefPubMedGoogle Scholar
  44. 44.
    Rozin L, Koehler SA, Shakir A, Ladham S, Wecht CH. Kawasaki disease: a review of pathologic features of stage IV disease and two cases of sudden death among asymptotic young adults. Am J Forensic Med Pathol 2003; 24: 45–50.CrossRefPubMedGoogle Scholar
  45. 45.
    Sumitomo N, Karasawa K, Taniguchi K, Ichikawa R, Fukuhara J, Abe O et al. Association of sinus node dysfunction, atrioventricular node conduction abnormality and ventricular arrhythmia in patients with Kawasaki disease and coronary involvement. Circ J 2008; 72: 274–280.CrossRefPubMedGoogle Scholar
  46. 46.
    Haney I, Beghetti M, McCrindle BW, Gow RM. Ventricular arrhythmia complicating Kawasaki disease. Can J Cardiol 1995; 11: 931–933.PubMedGoogle Scholar
  47. 47.
    Yonesaka S, Nakada T, Sunagawa Y, Tomimoto K, Naka S, Takahashi T et al. Endomyocardial biopsy in children with Kawasaki disease. Acta Paediatr Jpn 1989; 31: 706–711.PubMedGoogle Scholar
  48. 48.
    Yutani C, Okano K, Kamiya T, Oguchi K, Kozuka T, Ota M et al. Histopathological study on right endomyocardial biopsy of Kawasaki disease. Br Heart J 1980; 43: 589–592.CrossRefPubMedGoogle Scholar
  49. 49.
    Nakada T, Yonesaka S, Sunagawa Y, Tomimoto K, Takahashi T, Matsubara T et al. Coronary arterial calcification in Kawasaki disease. Acta Paediatr Jpn 1991; 33: 443–449.PubMedGoogle Scholar
  50. 50.
    Ino T, Shimazaki S, Akimoto K, Park I, Nishimoto K, Yabuta K et al. Coronary artery calcification in Kawasaki disease. Pediatr Radiol 1990; 20: 520–523.CrossRefPubMedGoogle Scholar
  51. 51.
    Doi YL, Hamashige N, Odawara H, Kuzume O, Chikamori T, Ozawa T. Ring-calcification of coronary artery aneurysms in an adolescent. Chest 1987; 92: 1118–1120.CrossRefPubMedGoogle Scholar
  52. 52.
    Muneuchi J, Joo K, Morihana E, Mizushima A. Detectable silent calcification in a regressed coronary artery aneurysm of a young adult with a history of kawasaki disease. Pediatr Cardiol 2008; 29: 195–197.CrossRefPubMedGoogle Scholar
  53. 53.
    Niwa K, Tashima K, Kawasoe Y, Okajima Y, Nakajima H, Terai M. Magnetic resonance imaging of myocardial infarction in Kawasaki disease. American Heart J 1990; 119: 1293–302.CrossRefGoogle Scholar
  54. 54.
    Su JT, Chung T, Kovalchin JP. Magnetic resonance imaging of coronary and systemic aneurysms in Kawasaki disease. Cardiol Young 2004; 14: 198–199.CrossRefPubMedGoogle Scholar
  55. 55.
    Fujiwara M, Yamada TN, Ono Y, Yoshibayashi M, Kamiya T, Furukawa S. Magnetic resonance imaging of old myocardial infarction in young patients with a history of Kawasaki disease. Clin Cardiol 2001; 24: 247–252.CrossRefPubMedGoogle Scholar
  56. 56.
    Greil GF, Seeger A, Miller S, Claussen CD, Hofbeck M, Botnar RM et al. Coronary magnetic resonance angiography and vessel wall imaging in children with Kawasaki disease. Pediatr Radiol 2007; 37: 666–673.CrossRefPubMedGoogle Scholar
  57. 57.
    McMahon CJ, Su JT, Taylor MD, Krishnamurthy R, Muthupillai R, Kovalchin JP et al. Images in cardiovascular medicine. Detection of active coronary arterial vasculitis using magnetic resonance imaging in Kawasaki disease. Circulation 2005; 112: e315–e316.PubMedGoogle Scholar
  58. 58.
    Mavrogeni S, Papadopoulos G, Cokkinos D. Magnetic resonance imaging in the evaluation of Kawasaki disease. Hellenic J Cardiol 2005; 46: 240–241.PubMedGoogle Scholar
  59. 59.
    Sohn S, Kim HS, Lee SW. Multidetector row computed tomography for follow-up of patients with coronary artery aneurysms due to Kawasaki disease. Pediatr Cardiol 2004; 25: 35–39.CrossRefPubMedGoogle Scholar
  60. 60.
    Kanamaru H, Sato Y, Takayama T, Ayusawa M, Karasawa K, Sumitomo N et al. Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease. American J Cardiology 2005; 95: 522–525.CrossRefGoogle Scholar
  61. 61.
    Goo HW, Park IS, Ko JK, Kim YH. Coronary CT angiography and MR angiography of Kawasaki disease. Pediatr Radiol 2006; 36: 697–705.CrossRefPubMedGoogle Scholar
  62. 62.
    Aggarwala G, Iyengar N, Burke SJ, van Beek EJ, Thompson B, Law I et al. Kawasaki disease: role of coronary CT angiography. Int J Cardiovasc Imaging 2006; 22: 803–805.CrossRefPubMedGoogle Scholar
  63. 63.
    Chu WC, Mok GC, Lam WW, Yam MC, Sung RY. Assessment of coronary artery aneurysms in paediatric patients with Kawasaki disease by multidetector row CT angiography: feasibility and comparison with 2D echocardiography. Pediatr Radiol 2006; 36: 1148–1153.CrossRefPubMedGoogle Scholar
  64. 64.
    Ino T, Nishimoto K, Akimoto K, Park I, Shimazaki S, Yabuta K et al. Percutaneous transluminal coronary angioplasty for Kawasaki disease: a case report and literature review. Pediatr Cardiol 1991; 12: 33–35.CrossRefPubMedGoogle Scholar
  65. 65.
    Akagi T. Interventions in Kawasaki Disease. Pediatr Cardiol 2005; 26: 206–212.CrossRefPubMedGoogle Scholar
  66. 66.
    Ishii M, Ueno T, Ikeda H, Iemura M, Sugimura T, Furui J, et al. Sequential follow-up results of catheter intervention for coronary artery lesions after Kawasaki disease: quantitative coronary artery angiography and intravascular ultrasound imaging study. Circulation 2002; 105: 3004–3010.CrossRefPubMedGoogle Scholar
  67. 67.
    Ishii M, Ueno T, Akagi T, Baba K, Harada K, Hamaoka K, et al. Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease. Pediatr Int 2001; 43: 558–562.CrossRefPubMedGoogle Scholar
  68. 68.
    Kitamura S. The role of coronary bypass operation on children with Kawasaki disease. Coron Artery Dis 2002; 13: 437–447.CrossRefPubMedGoogle Scholar
  69. 69.
    Tsuda E, Kitamura S. National survey of coronary artery bypass grafting for coronary stenosis caused by Kawasaki disease in Japan. Circulation 2004; 110: II61–1166.CrossRefPubMedGoogle Scholar
  70. 70.
    Gotteiner N, Mavroudis C, Backer CL, Pahl E, Duffy CE, Dalzell V et al. Coronary artery bypass grafting for Kawasaki disease. Pediatr Cardiol 2002; 23: 62–67.CrossRefPubMedGoogle Scholar
  71. 71.
    Checchia PA, Pahl E, Shaddy RE, Shulman ST. Cardiac transplantation for Kawasaki disease. Pediatrics 1997; 100: 695–699.CrossRefPubMedGoogle Scholar
  72. 72.
    Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110: 2747–2771.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2009

Authors and Affiliations

  1. 1.Departments of PediatricsUCSD School of Medicine, Rady Children’s HospitalLa JollaUSA
  2. 2.Division of Allergy, Immunology, and Rheumatology, Director, Kawasaki Disease Research Center, Dept. of Pediatrics 0641UCSD School of Medicine and Rady Children’s HospitalLa JollaUSA

Personalised recommendations