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Kawasaki Disease: Recent Diagnostics, Treatment, and Predictors for Treatment Failure and Coronary Artery Involvement

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Abstract

Purpose of Review

Kawasaki disease (KD) is a medium vessel vasculitis in pediatric patients with a predilection for coronary artery involvement. The disease can be complete or incomplete but generally consists of a fever longer than 5 days, bilateral conjunctivitis, rash, edema, cervical adenopathy, and mucosal involvement. Mainstay of therapy includes IV immunoglobulin and aspirin. The goal of this article is to identify recent research that focuses on the newest diagnostic tools, predictive factors for coronary involvement, and treatment failure, as well as the most recent literature on treatment.

Recent Findings

New diagnostic tools have been described that help separate febrile children with KD by only using lab parameters rather than subjective, clinical findings. We explore recent publications on several factors that can predict coronary artery involvement in Kawasaki disease as well as IV immunoglobulin (IVIG) failure including biomarkers such as C-reactive protein (CRP), genetic variants, male sex, and myocardial strain imaging.

Summary

Early suspicion and recognition of Kawasaki disease are essential for timely treatment so that devastating cardiovascular complications can be prevented. Further research is needed to develop and validate predictive models that can be used clinically to diagnose our pediatric population, identify patients at higher risk for coronary involvement, and identify those at risk for treatment failure.

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A review of the license permissions form from Frontiers in Pediatrics for Table 2 indicates an open-access article permitting unrestricted use, distribution, and reproduction under any medium as long as the author and journal have been credited accordingly with citations: https://doi.org/10.3389/fped.2019.00011 Example from: https://www.frontiersin.org/articles/10.3389/fped.2019.00011/full.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Department of Emergency Medicine, MetroHealth and Cleveland Clinic, Cleveland, USA

    Elda Tutic

  2. Department of Internal Medicine, The Warren Alpert Medical School of Brown University, Richmond, USA

    Kathryn Evey

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  1. Elda Tutic
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  2. Kathryn Evey
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E.T wrote the main manuscript text and K.E prepared the final edits, figures, and tables. All authors reviewed the manuscript.

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Correspondence to Elda Tutic.

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Tutic, E., Evey, K. Kawasaki Disease: Recent Diagnostics, Treatment, and Predictors for Treatment Failure and Coronary Artery Involvement. Curr Emerg Hosp Med Rep 11, 158–164 (2023). https://doi.org/10.1007/s40138-023-00273-4

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  • DOI: https://doi.org/10.1007/s40138-023-00273-4

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