Topzle Topzle

Kawasaki disease

Updated: Wikipedia source

Kawasaki disease

Kawasaki disease (also known as mucocutaneous lymph node syndrome) is a syndrome of unknown cause that results in a fever and mainly affects children under 5 years of age. It is a form of vasculitis, in which medium-sized blood vessels become inflamed throughout the body. The fever typically lasts for more than five days and is not affected by usual medications. Other common symptoms include large lymph nodes in the neck, a rash in the genital area, lips, palms, or soles of the feet, and red eyes. Within three weeks of the onset, the skin from the hands and feet may peel, after which recovery typically occurs. The disease is the leading cause of acquired heart disease in children in developed countries, which include the formation of coronary artery aneurysms and myocarditis. While the specific cause is unknown, it is thought to result from an excessive immune response to particular infections in children who are genetically predisposed to those infections. It is not an infectious disease, that is, it does not spread between people. Diagnosis is usually based on a person's signs and symptoms. Other tests such as an ultrasound of the heart and blood tests may support the diagnosis. Diagnosis must take into account many other conditions that may present similar features, including scarlet fever and juvenile rheumatoid arthritis. Multisystem inflammatory syndrome in children, a "Kawasaki-like" disease associated with COVID-19, appears to have distinct features.Another disease that can originally be presented with the same symptoms is measles. This is due to similar symptoms such as red eyes, persistent fever, and swollen hands/feet. However, Kawasaki disease is not spread the way measles can be spread from person to person. Typically, initial treatment of Kawasaki disease consists of high doses of aspirin and immunoglobulin. Usually, with treatment, fever resolves within 24 hours and full recovery occurs. If the coronary arteries are involved, ongoing treatment or surgery may occasionally be required. Without treatment, coronary artery aneurysms occur in up to 25% and about 1% die. With treatment, the risk of death is reduced to 0.17%. People who have had coronary artery aneurysms after Kawasaki disease require lifelong cardiological monitoring by specialized teams. Kawasaki disease is rare. It affects between 8 and 67 per 100,000 people under the age of five except in Japan, where it affects 124 per 100,000. Boys are more commonly affected than girls. The disorder is named after Japanese pediatrician Tomisaku Kawasaki, who first described it in 1967.

Infobox

Other names
Kawasaki syndrome, mucocutaneous lymph node syndrome
Specialty
Pediatrics, Rheumatology, Immunology
Symptoms
Fever 5 days, large lymph nodes, rash, sore throat, diarrhea
Complications
Coronary artery aneurysms
Usual onset
< 5 years old
Duration
3 weeks
Causes
Unknown
Risk factors
Age of < 5 years old, genetics
Diagnostic method
Based on symptoms, ultrasound of the heart
Differential diagnosis
Scarlet fever, juvenile rheumatoid arthritis, paediatric multisystem inflammatory syndrome
Medication
Oral Aspirin and intravenous immunoglobulin
Prognosis
Mortality 0.17% with treatment
Frequency
8–124 per 100,000 people under five in Japan, 8-67 per 100,000 in other countries
Named after
Tomisaku Kawasaki

Tables

· Signs and symptoms
System
System
Less common manifestations
System
Less common manifestations
Manifestations
GIT
GIT
Less common manifestations
GIT
Less common manifestations
Diarrhea, chest pain, abdominal pain, vomiting, liver dysfunction, pancreatitis, hydrops gallbladder, parotitis, cholangitis, intussusception, intestinal pseudo-obstruction, ascites, splenic infarction
MSS
MSS
Less common manifestations
MSS
Less common manifestations
Polyarthritis and arthralgia
CVS
CVS
Less common manifestations
CVS
Less common manifestations
Myocarditis, pericarditis, tachycardia, valvular heart disease
GU
GU
Less common manifestations
GU
Less common manifestations
Urethritis, prostatitis, cystitis, priapism, interstitial nephritis, orchitis, nephrotic syndrome
CNS
CNS
Less common manifestations
CNS
Less common manifestations
Lethargy, semicoma, aseptic meningitis, and sensorineural deafness
RS
RS
Less common manifestations
RS
Less common manifestations
Shortness of breath, influenza-like illness, pleural effusion, atelectasis
Skin
Skin
Less common manifestations
Skin
Less common manifestations
Erythema and induration at BCG vaccination site, Beau's lines, and finger gangrene
Source: review, table.
Source: review, table.
Less common manifestations
Source: review, table.
Less common manifestations
System
Manifestations
GIT
Diarrhea, chest pain, abdominal pain, vomiting, liver dysfunction, pancreatitis, hydrops gallbladder, parotitis, cholangitis, intussusception, intestinal pseudo-obstruction, ascites, splenic infarction
MSS
Polyarthritis and arthralgia
CVS
Myocarditis, pericarditis, tachycardia, valvular heart disease
GU
Urethritis, prostatitis, cystitis, priapism, interstitial nephritis, orchitis, nephrotic syndrome
CNS
Lethargy, semicoma, aseptic meningitis, and sensorineural deafness
RS
Shortness of breath, influenza-like illness, pleural effusion, atelectasis
Skin
Erythema and induration at BCG vaccination site, Beau's lines, and finger gangrene
Source: review, table.
· Diagnosis
Fever of ≥5 days' duration associated with at least four† of these five changes
Fever of ≥5 days' duration associated with at least four† of these five changes
Criteria for diagnosis
Fever of ≥5 days' duration associated with at least four† of these five changes
Bilateral nonsuppurative conjunctivitis
Bilateral nonsuppurative conjunctivitis
Criteria for diagnosis
Bilateral nonsuppurative conjunctivitis
One or more changes of the mucous membranes of the upper respiratory tract, including throat redness, dry cracked lips, red lips, and "strawberry" tongue
One or more changes of the mucous membranes of the upper respiratory tract, including throat redness, dry cracked lips, red lips, and "strawberry" tongue
Criteria for diagnosis
One or more changes of the mucous membranes of the upper respiratory tract, including throat redness, dry cracked lips, red lips, and "strawberry" tongue
One or more changes of the arms and legs, including redness, swelling, skin peeling around the nails, and generalized peeling
One or more changes of the arms and legs, including redness, swelling, skin peeling around the nails, and generalized peeling
Criteria for diagnosis
One or more changes of the arms and legs, including redness, swelling, skin peeling around the nails, and generalized peeling
Polymorphous rash, primarily truncal
Polymorphous rash, primarily truncal
Criteria for diagnosis
Polymorphous rash, primarily truncal
Large lymph nodes in the neck (>15 mm in size)
Large lymph nodes in the neck (>15 mm in size)
Criteria for diagnosis
Large lymph nodes in the neck (>15 mm in size)
Disease cannot be explained by some other known disease process
Disease cannot be explained by some other known disease process
Criteria for diagnosis
Disease cannot be explained by some other known disease process
†A diagnosis of Kawasaki disease can be made if fever and only three changes are present if coronary artery disease is documented by two-dimensional echocardiography or coronary angiography.
†A diagnosis of Kawasaki disease can be made if fever and only three changes are present if coronary artery disease is documented by two-dimensional echocardiography or coronary angiography.
Criteria for diagnosis
†A diagnosis of Kawasaki disease can be made if fever and only three changes are present if coronary artery disease is documented by two-dimensional echocardiography or coronary angiography.
Source: Nelson's essentials of pediatrics, Review
Source: Nelson's essentials of pediatrics, Review
Criteria for diagnosis
Source: Nelson's essentials of pediatrics, Review
Criteria for diagnosis
Fever of ≥5 days' duration associated with at least four† of these five changes
Bilateral nonsuppurative conjunctivitis
One or more changes of the mucous membranes of the upper respiratory tract, including throat redness, dry cracked lips, red lips, and "strawberry" tongue
One or more changes of the arms and legs, including redness, swelling, skin peeling around the nails, and generalized peeling
Polymorphous rash, primarily truncal
Large lymph nodes in the neck (>15 mm in size)
Disease cannot be explained by some other known disease process
†A diagnosis of Kawasaki disease can be made if fever and only three changes are present if coronary artery disease is documented by two-dimensional echocardiography or coronary angiography.
Source: Nelson's essentials of pediatrics, Review

References

  1. PubMed Health
    https://web.archive.org/web/20170911003355/https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0062985/
  2. Dermatology: 2-Volume Set
  3. Guidance – Paediatric multisystem inflammatory syndrome temporally associated with COVID-19
    https://www.rcpch.ac.uk/sites/default/files/2020-05/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf
  4. Yonsei Medical Journal
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687814
  5. Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult
    https://books.google.com/books?id=s91bCwAAQBAJ&pg=PA739
  6. Circulation
    https://doi.org/10.1161%2FCIR.0000000000000484
  7. Kawasaki Disease
  8. StatPearls
    https://web.archive.org/web/20200506143059/https://www.ncbi.nlm.nih.gov/books/NBK537163/
  9. Rheumatology (Oxford)
    https://discovery.ucl.ac.uk/id/eprint/10072207/1/SHARE%20KD%20Recommendations%20-%20Rheumatology%20Manuscript%20-%20270618%20-%20Final.pdf
  10. Nature Reviews. Rheumatology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271827
  11. Can J Cardiol
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9824951
  12. The Journal of Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403869
  13. www.valleychildrens.org
    https://www.valleychildrens.org/blog/can-you-spot-difference-conditions-mimic-measles-and-how-tell-them-apart
  14. "Merck Manual, Online edition: Kawasaki Disease"
    http://www.merck.com/mmpe/sec19/ch286/ch286d.html
  15. Heart
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057818
  16. Arerugi
    https://pubmed.ncbi.nlm.nih.gov/6062087
  17. Clinical Microbiology Reviews
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88887
  18. Japanese Heart Journal
    https://doi.org/10.1536%2Fihj.36.1
  19. Textbook of pediatric rheumatology
  20. Acta Paediatrica
    https://doi.org/10.1111%2Fj.1651-2227.1994.tb12985.x
  21. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2887%2980503-6
  22. Rheumatology International
    https://doi.org/10.1007%2Fs00296-011-2123-4
  23. The Journal of Pediatrics
    https://doi.org/10.1067%2Fmpd.2000.107890
  24. The New England Journal of Medicine
    https://doi.org/10.1056%2FNEJM199106063242305
  25. Korean Circulation Journal
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152734
  26. Anales de Pediatria
    https://www.analesdepediatria.org/es-incidencia-caracteristicas-clinicas-enfermedad-kawasaki-articulo-S1695403303781909
  27. Casopis Lekaru Ceskych
    https://pubmed.ncbi.nlm.nih.gov/18401983
  28. Pediatric Infectious Disease
    https://doi.org/10.1097%2F00006454-198505000-00010
  29. American Journal of Ophthalmology
    https://doi.org/10.1016%2FS0002-9394%2899%2900285-8
  30. The Pediatric Infectious Disease Journal
    https://pubmed.ncbi.nlm.nih.gov/2468129
  31. Journal of Paediatrics and Child Health
    https://doi.org/10.1111%2Fj.1440-1754.2008.01310.x
  32. Medicina Oral, Patologia Oral y Cirugia Bucal
    http://www.medicinaoral.com/pubmed/medoralv12_i8_pE560.pdf
  33. Anais Brasileiros de Dermatologia
    https://doi.org/10.1590%2FS0365-05962009000400002
  34. Pediatrics
    https://doi.org/10.1542%2Fpeds.93.3.525
  35. Journal of Pediatric Surgery
    https://cs.nyu.edu/~fergus/drafts/hydrops_gallbladder.pdf
  36. Korean Circulation Journal
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790127
  37. Anais Brasileiros de Dermatologia
    https://doi.org/10.1590%2FS0365-05962009000400002
  38. The Pediatric Infectious Disease Journal
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738931
  39. Archives of Disease in Childhood
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1718513
  40. Anales de Pediatria
    https://www.analesdepediatria.org/es-lineas-beau-enfermedad-kawasaki-articulo-13113031
  41. Anales Espanoles de Pediatria
    https://www.aeped.es/sites/default/files/anales/50-1-9.pdf
  42. European Journal of Pediatrics
    https://doi.org/10.1007%2Fs00431-005-1715-y
  43. The Pediatric Infectious Disease Journal
    https://doi.org/10.1097%2FINF.0b013e31814619ec
  44. Circulation
    https://doi.org/10.1161%2F01.CIR.87.5.1776
  45. Pathology International
    https://doi.org/10.1111%2Fj.1440-1827.1986.tb03119.x
  46. Journal of the American College of Cardiology
    https://doi.org/10.1016%2Fj.jacc.2009.11.067
  47. The Journal of Pediatrics
    https://doi.org/10.1067%2Fmpd.2002.122469
  48. "Clinical manifestations of Kawasaki disease"
    http://img.medscape.com/pi/emed/ckb/pediatrics_general/1331341-1331368-965367-2063095.jpg
  49. Italian Journal of Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116535
  50. Journal of Cardiography
    https://pubmed.ncbi.nlm.nih.gov/7264399
  51. Journal of General Internal Medicine
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852903
  52. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2886%2980689-8
  53. European Journal of Pediatrics
    https://doi.org/10.1007%2FBF01957725
  54. Pediatric Cardiology
    https://doi.org/10.1007%2FBF02315475
  55. Pediatrics
    https://web.archive.org/web/20200502132856/https://www.crd.york.ac.uk/crdweb/PrintPDF.php?AccessionNumber=11996000062&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2015+University+of+York%3Cbr+%2F%3E&AccessionNumber=11996000062&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2015+University+of+York%3Cbr+%2F%3E
  56. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2897%2970038-6
  57. Circulation
    https://doi.org/10.1161%2F01.cir.89.2.916
  58. Nihon Rinsho. Japanese Journal of Clinical Medicine
    https://pubmed.ncbi.nlm.nih.gov/18260333
  59. Acta Paediatrica Japonica
    https://doi.org/10.1111%2Fj.1442-200X.1991.tb02612.x
  60. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2886%2980878-2
  61. Circulation
    https://doi.org/10.1161%2F01.cir.94.6.1379
  62. Circulation
    https://doi.org/10.1161%2F01.CIR.75.2.387
  63. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2886%2980928-3
  64. The American Journal of Cardiology
    https://doi.org/10.1016%2F0002-9149%2888%2990950-2
  65. American Heart Journal
    https://doi.org/10.1016%2F0002-8703%2890%2990081-8
  66. Journal of the American College of Cardiology
    https://doi.org/10.1016%2FS0735-1097%2886%2980354-0
  67. The Journal of Heart Valve Disease
    https://pubmed.ncbi.nlm.nih.gov/8665019
  68. The American Journal of Cardiology
    https://www.academia.edu/14091468
  69. Acta Paediatrica Japonica
    https://doi.org/10.1111%2Fj.1442-200X.1996.tb03480.x
  70. Acta Paediatrica Japonica
    https://doi.org/10.1111%2Fj.1442-200X.1995.tb03368.x
  71. Revista da Associação Médica Brasileira
    https://doi.org/10.1016%2Fs2255-4823%2811%2970062-5
  72. Pediatric Cardiology
    https://doi.org/10.1007%2Fs00246-008-9296-y
  73. Circulation
    https://doi.org/10.1161%2F01.cir.94.9.2103
  74. Archives of Disease in Childhood
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083125
  75. Pediatrics International
    https://doi.org/10.1111%2Fj.1442-200x.2004.01929.x
  76. Journal of the American College of Cardiology
    https://doi.org/10.1016%2Fj.jacc.2003.08.030
  77. Journal of Pediatric Surgery
    https://doi.org/10.1016%2Fj.jpedsurg.2005.05.063
  78. Journal of Korean Medical Science
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526417
  79. Journal of Pediatric Surgery
    https://doi.org/10.1053%2Fjpsu.2001.22311
  80. Pediatrics
    https://doi.org/10.1542%2Fpeds.113.5.e504
  81. The Journal of Pediatrics
    https://doi.org/10.1067%2Fmpd.2003.232
  82. American Journal of Ophthalmology
    https://doi.org/10.1016%2F0002-9394%2882%2990465-2
  83. Journal of Pediatric Ophthalmology and Strabismus
    https://doi.org/10.3928%2F0191-3913-19810901-04
  84. Journal of Pediatric Ophthalmology and Strabismus
    https://doi.org/10.3928%2F0191-3913-20040501-12
  85. Journal of Pediatric Ophthalmology and Strabismus
    https://doi.org/10.3928%2F01913913-20070901-06
  86. Clinical Infectious Diseases
    https://doi.org/10.1093%2Fclinids%2F14.1.121
  87. Pediatric Neurology
    https://www.researchgate.net/publication/11761641
  88. No to Hattatsu = Brain and Development
    https://pubmed.ncbi.nlm.nih.gov/2223179
  89. Surgical Neurology
    https://doi.org/10.1016%2F0090-3019%2888%2990009-2
  90. European Journal of Paediatric Neurology
    https://doi.org/10.1053%2Fejpn.2001.0469
  91. Stroke
    https://doi.org/10.1161%2F01.STR.29.7.1320
  92. Pediatric Neurology
    https://doi.org/10.1016%2F0887-8994%2892%2990077-C
  93. Brain & Development
    https://doi.org/10.1016%2Fj.braindev.2005.04.003
  94. Pediatrics
    https://www.researchgate.net/publication/23147879
  95. American Journal of Otolaryngology
    https://kdfoundation.org/wp-content/uploads/2019/05/SNHL-.pdf
  96. Jornal de Pediatria
    https://doi.org/10.2223%2FJPED.669
  97. BMC Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1156909
  98. Archives of Pediatrics & Adolescent Medicine
    https://doi.org/10.1001%2Farchpedi.154.5.463
  99. Nature Reviews. Microbiology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7097362
  100. "Kawasaki Disease"
    http://www.americanheart.org/presenter.jhtml?identifier=4634
  101. "Kawasaki Disease: Causes"
    http://www.mayoclinic.com/health/kawasaki-disease/DS00576/DSECTION=causes
  102. Frontiers in Immunology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302019
  103. Frontiers in Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298241
  104. Clinical Immunology (Orlando, Fla.)
    https://doi.org/10.1016%2Fj.clim.2020.108385
  105. Journal of Epidemiology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771612
  106. International Journal of Rheumatic Diseases
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777874
  107. Current Opinion in Infectious Diseases
    https://doi.org/10.1097%2F00001432-200106000-00017
  108. Nature Reviews. Immunology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296515
  109. Current Rheumatology Reports
    https://www.researchgate.net/publication/339046947
  110. Scientific Reports
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3240972
  111. Geophysical Research Letters
    https://authors.library.caltech.edu/43425/1/grl50388.pdf
  112. Nature
    https://doi.org/10.1038%2F484021a
  113. Proceedings of the National Academy of Sciences of the United States of America
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050536
  114. European Journal of Pediatrics
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511310
  115. Textbook of Pediatric Rheumatology
    https://doi.org/10.1016%2FB978-0-323-24145-8.00035-1
  116. Cardiology Research
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011927
  117. Drug Discovery Today
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185772
  118. Nelson essentials of pediatrics
  119. Annals of the Rheumatic Diseases
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798210
  120. Journal of the American College of Cardiology
    https://doi.org/10.1016%2Fj.jacc.2015.12.073
  121. mayoclinic.org
    https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603
  122. American Family Physician
    http://www.aafp.org/afp/990600ap/3093.html
  123. "Kawasaki Disease Diagnostic Criteria"
    http://reference.medscape.com/calculator/kawasaki-disease-diagnostic-criteria
  124. Acta Paediatrica
    https://doi.org/10.1111%2Fj.1651-2227.2010.01875.x
  125. Vaccine
    https://doi.org/10.1016%2Fj.vaccine.2016.09.025
  126. Nature Reviews Rheumatology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554518
  127. www.who.int
    https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19
  128. emergency.cdc.gov
    https://emergency.cdc.gov/han/2020/han00432.asp
  129. Revista Española de Anestesiología y Reanimación (English Edition)
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739010
  130. Morbidity and Mortality Weekly Report
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7561225
  131. The Lancet
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351414
  132. JAMA
    https://doi.org/10.1001%2Fjama.2020.10370
  133. La Revue du Praticien
    https://pubmed.ncbi.nlm.nih.gov/18524103
  134. "necrotizing vasculitis – definition of necrotizing vasculitis"
    http://medical-dictionary.thefreedictionary.com/necrotizing+vasculitis
  135. Pediatric Nephrology
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908435
  136. European Review for Medical and Pharmacological Sciences
    https://pubmed.ncbi.nlm.nih.gov/17274537
  137. Anais Brasileiros de Dermatologia
    https://doi.org/10.1590%2FS0365-05962009000100008
  138. Ugeskrift for Laeger
    https://ugeskriftet.dk/videnskab/primaer-vaskulitis-i-barnealderen-nye-klassifikationskriterier
  139. Presse Médicale
    https://doi.org/10.1016%2Fj.lpm.2007.01.035
  140. Current Rheumatology Reports
    https://doi.org/10.1007%2Fs11926-000-0044-4
  141. "Who Kawasaki Disease Affects"
    https://web.archive.org/web/20081123064202/http://www.childrenshospital.org/clinicalservices/Site468/mainpageS468P5.html
  142. The Cochrane Database of Systematic Reviews
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544780
  143. Pediatrics
    https://doi.org/10.1542%2Fpeds.2022-059175
  144. www.pcori.org
    https://www.pcori.org/evidence-updates/comparing-two-treatments-ivig-resistant-kawasaki-disease
  145. Pediatrics
    https://doi.org/10.1542%2Fpeds.2004-1037
  146. The Cochrane Database of Systematic Reviews
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8765111
  147. Medscape – EMedicine
    https://web.archive.org/web/20090203130122/https://emedicine.medscape.com/article/804960-treatment
  148. PLOS ONE
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686074
  149. The Cochrane Database of Systematic Reviews
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953355
  150. The Lancet
    https://doi.org/10.1016%2FS0140-6736%2818%2932003-8
  151. The Journal of Pediatrics
    https://doi.org/10.1067%2Fmpd.2003.191
  152. The New England Journal of Medicine
    https://doi.org/10.1056%2FNEJMoa061235
  153. The Cochrane Database of Systematic Reviews
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139689
  154. The American Journal of Cardiology
    https://doi.org/10.1016%2FS0002-9149%2898%2900116-7
  155. Progress in Clinical and Biological Research
    https://pubmed.ncbi.nlm.nih.gov/3423060
  156. The American Journal of Cardiology
    https://doi.org/10.1016%2F0002-9149%2885%2990767-2
  157. The Journal of Pediatrics
    https://doi.org/10.1016%2FS0022-3476%2887%2980246-9
  158. Pediatrics International
    https://doi.org/10.1046%2Fj.1442-200X.2001.01464.x
  159. The Journal of Pediatrics
    https://doi.org/10.1067%2Fmpd.2000.107164
  160. Coronary Artery Disease
    https://web.archive.org/web/20170809110519/http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/MCA/A/00019501-920021200-00007.pdf
  161. Pediatrics
    https://doi.org/10.1542%2Fpeds.100.4.695
  162. Indian Journal of Pediatrics
    https://doi.org/10.1007%2Fs12098-017-2567-y
  163. Cardiovascular Rheumatic Diseases, An Issue of Rheumatic Disease Clinics, E-Book
    https://books.google.com/books?id=yB_QAgAAQBAJ&pg=PA66
  164. International Journal of Rheumatic Diseases
    https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-12-0568/_pdf
  165. ucsfbenioffchildrens.org
    https://www.ucsfbenioffchildrens.org/conditions/kawasaki-disease
  166. CDC
    https://www.cdc.gov/kawasaki/
  167. Pediatrics
    https://doi.org/10.1542%2Fpeds.112.3.495
  168. "BBC Health: Kawasaki Disease"
    https://web.archive.org/web/20110209002608/http://www.bbc.co.uk/health/physical_health/conditions/kawasaki2.shtml
  169. "Rare heart disease rate doubles"
    https://news.bbc.co.uk/2/hi/health/2043402.stm
  170. Rheumatology
    https://doi.org/10.1093%2Frheumatology%2Fkeaa111.129
  171. The Japan Times
    https://www.japantimes.co.jp/news/2012/03/17/national/kawasaki-disease-in-kids-at-record-high/
  172. Shonika Rinsho
  173. Pediatrics
    https://doi.org/10.1542%2Fpeds.54.3.271
  174. American Journal of Diseases of Children
    https://doi.org/10.1001%2Farchpedi.1976.02120070025006
  175. St Bartholomew's Hosp Rep
    https://books.google.com/books?id=tJIEAAAAQAAJ&pg=PA148
  176. International Journal of Rheumatic Diseases
    https://escholarship.org/uc/item/6vx3n630
  177. Kawasaki disease: Proceedings of the 5th International Kawasaki Disease Symposium, Fukuoka, Japan, 22–25 May 1995
    https://search.worldcat.org/issn/0531-5131
Image
Source:
Tip: Wheel or +/− to zoom, drag to pan, Esc to close.