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Jiao F, Pan Y, Du Z, Deng F, Yang X, Wang H, Shen J, Xiang W, Mu Z, Gao C, Bai J. Guideline for the diagnosis and treatment of incomplete Kawasaki disease in children in China. BMC Pediatr 2024; 24:477. [PMID: 39060924 PMCID: PMC11282762 DOI: 10.1186/s12887-024-04961-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a pyretic ailment predominantly observed in children aged below 5 years. There is currently a dearth of precise markers for timely identification of incomplete Kawasaki disease (IKD). It is imperative to develop updated, comprehensive, and evidence-based guidelines to effectively direct clinical practice. METHODS The guideline development group comprised individuals with diverse expertise in both content and methodology and carried out an extensive exploration of the following digital repositories: CNKI, VIP, Wanfang Data, UpToDate, BMJ, Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed. The entire period from the establishment of these databases until January 1, 2024 was covered. To evaluate IKD, systematic reviews and randomised controlled trials were assessed using the risk of prejudice instrument specified in the Cochrane Handbook, along with the evidence robustness framework established by the GRADE group. The recommendations were formulated based on the findings, considering the evidence strength. After several iterations of expert consensus, the relevant professional committees in China endorsed the ultimate guideline. RESULTS These guidelines address clinical questions regarding the classification and definition of KD, diagnosis of IKD, treatment during the acute phase of IKD, and follow-up of IKD. CONCLUSIONS To provide healthcare professionals with guidance and decision-making bases for the diagnosis and treatment of IKD in China, 13 recommendations were formulated based on expert consensus and evidence of best practices.
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Affiliation(s)
- Fuyong Jiao
- Children's Hospital, Shaanxi Provincial People's Hospital, Xian, 710000, China
| | - Yan Pan
- Department of Pediatrics, the First Affiliated Hospital of Yangtze University, Jingzhou, 434000, China.
| | - Zhongdong Du
- National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100000, China.
| | - Fangming Deng
- Editorial Department of Chinese Journal of Contemporary Pediatrics, Xiangya Hospital, Central South University, Changsha, 410000, China
| | - Xiaodong Yang
- Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, 200120, China
| | - Hong Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Jie Shen
- Department of Cardiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, 200120, China
| | - Wei Xiang
- Hainan Women and Children's Medical Center, School of Pediatrics, Hainan Medical University, Haikou, 570100, China
| | - Zhilong Mu
- Children's Hospital, Shaanxi Provincial People's Hospital, Xian, 710000, China
| | - Chunyan Gao
- Department of Pediatrics, the Affiliated Hospital of Yan'an University, Yan'an, 716000, China
| | - Jinmei Bai
- Department of Pediatrics, the Affiliated Hospital of Yan'an University, Yan'an, 716000, China
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Marutani K, Murata K, Mizuno Y, Onoyama S, Hoshina T, Yamamura K, Furuno K, Sakai Y, Kishimoto J, Kusuhura K, Hara T. Respiratory viral infections and Kawasaki disease: A molecular epidemiological analysis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00112-9. [PMID: 39034166 DOI: 10.1016/j.jmii.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/21/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND/PURPOSE Recent large-scale epidemiological studies have revealed significant temporal associations between certain viral infections and the subsequent development of Kawasaki disease (KD). Despite these associations, definitive laboratory evidence linking acute or recent viral infections to KD cases remains elusive. The objective of this study is to employ a molecular epidemiological approach to investigate the temporal association between viral infections and the development of KD. METHODS We analyzed 2460 patients who underwent the FilmArray® Respiratory Panel test between April 2020 and September 2021. RESULTS Following the application of inclusion criteria, 2402 patients were categorized into KD (n = 148), respiratory tract infection (n = 1524), and control groups (n = 730). The KD group exhibited higher positive rates for respiratory syncytial virus (RSV), human rhinovirus/enterovirus (hRV/EV), parainfluenza virus (PIV) 3, and adenovirus (AdV) compared to the control group. Additionally, coinfections involving two or more viruses were significantly more prevalent in the KD group. Notably, RSV-positive, hRV/EV-positive, and PIV3-positive KD patients exhibited a one-month delay in peak occurrence compared to non-KD patients positive for corresponding viruses. In contrast, AdV-positive KD cases did not show a one-month delay in peak occurrence. Moreover, anti-RSV, anti-PIV3, and anti-AdV antibody-positive rates or antibody titers were higher in RSV-, PIV3-, and AdV-positive KD cases, respectively, compared to non-KD cases with the same viral infections. CONCLUSION Recent infection with RSV, PIV3, or AdV, occasionally in conjunction with other viruses, may contribute to the pathogenesis of KD as infrequent complications.
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Affiliation(s)
- Kentaro Marutani
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Kenji Murata
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Yumi Mizuno
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Sagano Onoyama
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishi-ku Kitakyushu-shi, Fukuoka, 807-8555, Japan
| | - Kenichiro Yamamura
- Department of Cardiology and Intensive Care, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Kenji Furuno
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Kusuhura
- Office of Clinical Education and Professional Development, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan
| | - Toshiro Hara
- Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan.
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Yang P, Zhang J, Feng S, Yi Q. A prediction model for differentiating recurrent Kawasaki disease from other febrile illnesses. Eur J Intern Med 2024; 125:148-151. [PMID: 38519309 DOI: 10.1016/j.ejim.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Penghui Yang
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, National Clinical Research Center for Child Health and Disorders, National Clinical Key Cardiovascular Specialty, Children's Hospital of Chongqing Medical University, 400014, Chongqing, China
| | - Jing Zhang
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, National Clinical Research Center for Child Health and Disorders, National Clinical Key Cardiovascular Specialty, Children's Hospital of Chongqing Medical University, 400014, Chongqing, China
| | - Siqi Feng
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, National Clinical Research Center for Child Health and Disorders, National Clinical Key Cardiovascular Specialty, Children's Hospital of Chongqing Medical University, 400014, Chongqing, China
| | - Qijian Yi
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, National Clinical Research Center for Child Health and Disorders, National Clinical Key Cardiovascular Specialty, Children's Hospital of Chongqing Medical University, 400014, Chongqing, China.
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Chen X, Gao L, Zhen Z, Wang Y, Na J, Yu W, Tian Z, Yuan Y, Qian S. Incidence of coronary artery lesions in children with recurrent Kawasaki disease. Expert Rev Clin Immunol 2024; 20:673-678. [PMID: 38315096 DOI: 10.1080/1744666x.2024.2314213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE Coronary artery lesions (CALs) are a major complication of Kawasaki disease (KD); however, data on CAL incidence and risk factors in recurrent KD are limited. METHODS Ninety-seven children with recurrent KD were retrospectively enrolled from 2013 to 2022, and CAL incidence was tracked during admission, discharge, and during follow-up. RESULTS Initially, 27.8% had CAL at admission and discharge, declining to 7.2% at 12 months post-discharge. Most patients (66 of 97, 68.0%) did not exhibit CAL at any of the time points, 7 cases presented CAL at all time points, indicating a persistent CAL. The remaining 20 cases presented CAL at admission but recovered at discharge or during follow-up. Notably, transient CALs had presented at discharge, or during the follow-up, but finally resolved at 12 months after discharge. Notably, prior IVIG resistance and increased prothrombin time seemed associated with CAL in recurrent KD, suggesting they could help identify patients needing close monitoring. CONCLUSION The study highlights decreasing CAL incidence over time in recurrent KD but with diverse patterns, emphasizing the importance of monitoring and further investigations to confirm these findings.
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Affiliation(s)
- Xi Chen
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lu Gao
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhen Zhen
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Wang
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jia Na
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wen Yu
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhiyu Tian
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yue Yuan
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Suyun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Yang P, Zhang J, Liu Y, Feng S, Yi Q. Prediction of Coronary Artery Lesions in Patients With Recurrent Kawasaki Disease. Pediatr Infect Dis J 2024; 43:101-108. [PMID: 37922481 DOI: 10.1097/inf.0000000000004146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
BACKGROUND A subset of patients with Kawasaki disease (KD) will suffer recurrence. However, there is still a lack of accurate prediction models for coronary artery lesions (CAL) in recurrent KD patients. It is necessary to establish a new nomogram model for predicting CAL in patients with recurrent KD. METHODS Data from patients with recurrent KD between 2015 and 2021 were retrospectively reviewed. After splitting the patients into training and validation cohorts, the least absolute shrinkage and selection operator was used to select the predictors of CAL and multivariate logistic regression was used to construct a nomogram based on the selected predictors. The application of area under the receiver operating characteristic curve (AUC), calibration curves, Hosmer-Lemeshow test, Brier score and decision curve analysis were used to assess the model performance. RESULTS A total of 159 recurrent KD patients were enrolled, 66 (41.5%) of whom had CAL. Hemoglobin levels, CAL at the first episode, and intravenous immunoglobulin resistance at recurrence were identified by the least absolute shrinkage and selection operator regression analysis as significant predictors. The model incorporating these predictors showed good discrimination (AUC, 0.777) and calibration capacities (Hosmer-Lemeshow P value, 0.418; Brier score, 0.190) in the training cohort. Application of the model to the validation cohort yielded an AUC of 0.741, a Hosmer-Lemeshow P value of 0.623 and a Brier score of 0.190. The decision curve analysis demonstrated that the nomogram model was clinically useful. CONCLUSIONS The proposed nomogram model could help clinicians assess the risk of CAL in patients with recurrent KD.
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Affiliation(s)
- Penghui Yang
- From the Department of Cardiovascular Medicine
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Zhang
- From the Department of Cardiovascular Medicine
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yihao Liu
- From the Department of Cardiovascular Medicine
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Siqi Feng
- From the Department of Cardiovascular Medicine
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qijian Yi
- From the Department of Cardiovascular Medicine
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Kim SY, Shin JS, Jang MS, Kim J. Clinical characteristics of patients with recurrent Kawasaki disease: a nationwide cohort study of 19 456 patients with minimum 3-year follow up. Arch Dis Child 2023; 108:307-312. [PMID: 36549869 DOI: 10.1136/archdischild-2022-324467] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To identify the clinical characteristics of patients with recurrent Kawasaki disease (KD). DESIGN A nationwide, population-based, cohort study using the Korean National Health Insurance claims database between 2013 and 2016. PATIENTS A total of 19 456 patients under the age of 5 years who were diagnosed with initial episode of KD were included. A minimum follow-up period of 3 years was mandatory for inclusion. MAIN OUTCOME MEASURES The epidemiological and clinical profiles were compared between KD patients with and without recurrence. RESULTS The overall recurrence rate of KD was 3.84% (n=748), and the median interval to recurrence was 498 days (IQR: 257-860 days). Approximately 70% of all recurrences occurred within 2 years of the initial diagnosis. The annual proportions of recurrence were 40%, 28%, 18%, 8% and 4% from the first to the fifth year following the initial episode, respectively. Recurrence rates were significantly higher in patients aged <1 year than in those aged 4-5 years (4.65% vs 2.22%) and those who showed resistance to an initial dose of intravenous immunoglobulin (IVIG) (10.00% vs 3.18%). Allergic comorbidities and coronary artery complications at the initial episode were not associated with increased rates of recurrence. CONCLUSIONS We clearly identified the annual recurrence rates and their intervals from the initial episode according to the various factors identified, including young age and resistance to initial IVIG. Our results, based on a nationwide cohort, can be used as reference for follow-up management in patients with KD and in future studies.
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Affiliation(s)
- Sin Young Kim
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ji Seong Shin
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Min Sik Jang
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jihye Kim
- Division of Infection, Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
- College of Medicine, Hallym University, Chuncheon, Korea
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焦 富, 穆 志, 杜 忠, 杨 晓, 沈 捷, 向 伟, 王 虹. [Diagnosis and treatment of incomplete Kawasaki disease in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:238-243. [PMID: 36946156 PMCID: PMC10032064 DOI: 10.7499/j.issn.1008-8830.2209127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/31/2022] [Indexed: 03/23/2023]
Abstract
Kawasaki disease (KD) is a febrile disease mainly observed in children aged <5 years, with medium- and small-vessel vasculitis as the main lesion. Although KD has been reported for more than 50 years and great progress has been made in the etiology and pathology of KD in recent years, there is still a lack of specific indicators for the early diagnosis of KD, especially with more difficulties in the diagnosis of incomplete Kawasaki disease (IKD). At present, there are no clear diagnostic criteria for IKD, which leads to the failure of the timely identification and standardized treatment of IKD in clinical practice and even induce the development of coronary artery lesion. This article reviews the concept, epidemiological features, diagnosis, treatment, and follow-up management of IKD, in order to deepen the understanding of IKD among clinical workers and help to improve the clinical diagnosis and treatment of KD in China.
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Affiliation(s)
| | | | - 忠东 杜
- 国家儿童医学中心/首都医科大学 附属北京儿童医院北京100045
| | | | - 捷 沈
- 国家儿童医学 中心/上海交通大学医学院附属儿童医学中心上海200120
| | - 伟 向
- 海南省妇女儿童医学中心/国家卫健委热带病 防治重点实验室,海南海口570206
| | - 虹 王
- 中国医科大学附属盛京医院小儿心脏病科,辽宁沈阳110004
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Chen X, Gao L, Zhen Z, Wang Y, Na J, Yu W, Chu X, Yuan Y, Qian S. Risk Factors and Predictive Models for Intravenous Immunoglobulin Resistance in Children with Recurrent Kawasaki Disease. J Inflamm Res 2022; 15:2877-2889. [PMID: 35571506 PMCID: PMC9091694 DOI: 10.2147/jir.s360802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore the risk factors and develop predictive models for intravenous immunoglobulin (IVIG) resistance in children with recurrent Kawasaki disease (KD). Patients and Methods Patients with recurrent KD were retrospectively reviewed. Clinical and laboratory data at recurrence were collected and compared between patients with and without IVIG resistance. The patients were randomly divided into training and validation cohorts for model development and validation. All variables were subjected to standard Lasso and its variant group Lasso analyses, respectively, to construct predictive models. Model performance was evaluated by receiver operating characteristics (ROC) curves, calibration curves, and Hosmer-Lemeshow tests. Results A total of 90 children with recurrent KD were included. A total of 16 cases were IVIG resistant. The patients with IVIG resistance had higher age and IVIG resistance probability at the first episode, increased CRP levels, neutrophil count, neutrophil percentage, direct bilirubin level, prothrombin time, and international normalized ratio, and decreased lymphocyte count, lymphocyte percentage, and serum sodium levels. Five variables including age and IVIG resistance at the first episode, lymphocytes count, serum sodium levels, and CRP levels were finally selected by standard Lasso (lLasso model) and four variables including age and IVIG resistance at the first episode, neutrophil percentage, and CRP levels were selected by group Lasso (gLasso). ROC curves suggested lLasso and gLasso models had similar excellent discrimination in both the training cohort (0.895 vs 0.906) and the validation cohort (0.855 vs 0.909). Hosmer-Lemeshow tests suggested the two models exerted a good calibration. Two nomograms were also constructed to facilitate the potential application of the two models. Conclusion Age and IVIG resistance at the first episode and some laboratory variables may be risk factors for IVIG resistance in recurrent KD. Two predictive models for IVIG resistance with excellent performance were established in recurrent KD. External validation should be performed before clinical use.
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Affiliation(s)
- Xi Chen
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Lu Gao
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Zhen Zhen
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Ying Wang
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Jia Na
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Wen Yu
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Xinyuan Chu
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China
| | - Yue Yuan
- Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China,Correspondence: Yue Yuan, Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56, Nanlishilu, District Xicheng, Beijing, 100045, People’s Republic of China, Email ;
| | - Suyun Qian
- Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China,Suyun Qian, Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56, Nanlishilu, District Xicheng, Beijing, 100045, People’s Republic of China, Email ;
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Identifying Circulating MicroRNA in Kawasaki Disease by Next-Generation Sequencing Approach. Curr Issues Mol Biol 2021; 43:485-500. [PMID: 34202375 PMCID: PMC8929010 DOI: 10.3390/cimb43020037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022] Open
Abstract
Kawasaki disease (KD) typically occurs in children aged under 5 years and can cause coronary artery lesions (CALs). Early diagnosis and treatment with intravenous immunoglobulin can reduce the occurrence of CALs; therefore, identifying a good biomarker for diagnosing KD is essential. Here, using next-generation sequencing in patients with recurrent KD, those with viral infection, and healthy controls, we identified dysregulated circulating microRNAs as diagnostic biomarkers for KD. Pathway enrichment analysis illustrated the putative role of these miRNAs in KD progression. Their expression levels were validated using real-time polymerase chain reaction (qPCR). Fifteen dysregulated circulating miRNAs (fold changes >2 and <0.5) were differentially expressed in the recurrent KD group compared with the viral infection and control groups. These miRNAs were significantly involved in the transforming growth factor-β, epithelial-mesenchymal transition, and cell apoptosis signaling pathways. Notably, their expression levels were frequently restored after intravenous immunoglobulin treatment. Among the candidates, miR-24-3p expression level was significantly higher in patients with recurrent KD compared with healthy controls or viral infection controls (p < 0.001). Receiver operating characteristic analysis revealed that high miR-24-3p expression levels may be a potential biomarker for KD diagnosis. In conclusion, we identified miR-24-3p significantly higher in KD patients, which may be a potential diagnostic biomarker for KD.
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Abstract
BACKGROUND Some patients with Kawasaki disease (KD) have siblings who developed the same disease. Using a large-scale epidemiologic dataset, the present study aimed to determine the clinical characteristics of this population. METHODS We analyzed 89,725 patients diagnosed with KD during 2011-2018 who were registered in the nationwide Japanese KD survey database. Multivariable logistic regression analyses were performed to determine factors associated with sibling history of KD. RESULTS Of the 89,725 patients, 1777 (2%) had sibling history of KD. Annual prevalence ranged from 1.5% to 2.3% during the study period and showed a tendency toward an increasing trend. Patients with recurrent KD and parental history of KD were significantly associated with sibling history of KD (adjusted odds ratio [95% confidence interval] = 2.15 [1.82-2.54] and 2.64 [2.02-3.47], respectively). Although patients with a sibling history of KD were significantly associated with initial intravenous immunoglobulin treatment resistance (1.14 [1.02-1.28]), no significant association was found between sibling history and coronary artery abnormality development. Among patients with a sibling history of KD, male patients were less likely to have recurrent KD than female patients (0.68 [0.49-0.96]). CONCLUSIONS The significant association between sibling history and parental history may indicate genetic susceptibility to KD onset. Among those with a sibling history, recurrent KD was more likely to occur in female patients. Further studies focusing on this population may contribute toward identification of the cause of KD onset.
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Medaglia AA, Siracusa L, Gioè C, Giordano S, Cascio A, Colomba C. Kawasaki disease recurrence in the COVID-19 era: a systematic review of the literature. Ital J Pediatr 2021; 47:95. [PMID: 33874991 PMCID: PMC8054252 DOI: 10.1186/s13052-021-01041-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/26/2021] [Indexed: 12/14/2022] Open
Abstract
Kawasaki disease (KD) is a vasculitis of unknown origin of small and medium caliber blood vessels, especially involving coronary arteries and is the leading cause of acquired heart disease in childhood in developed countries. Although rarely, it can recur: most recurrences occur within 2 years of the initial episode. No data are available on incidence of recurrent KD in Europe and multiple recurrences are rarely seen. We reviewed the medical literature on Kawasaki disease recurrence and reported a new case of Kawasaki disease recurrence in a child with SARS-CoV-2 infection. We believe that in our case SARS Cov2 acted as a trigger capable to determine, in a genetically susceptible individual, a second recurrence of the disease. In the Covid-19 era we affirm the importance for Kawasaki disease to be tested for SARS Cov2 infection.
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Affiliation(s)
- Alice Annalisa Medaglia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy.
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy.
| | - Lucia Siracusa
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Claudia Gioè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Salvatore Giordano
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
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