Purpose : Without a specific diagnostic method, the clinical diagnostic criteria for atypical Kawasaki disease is known as the presence of coronary artery changes in a patient who did not meet the already estabilished clinical criteria. With this criteria, we are put into dilemma because atypical Kawasaki disease should exhibit coronary artery disease. So, we demonstrated the rate of coronary artery involvement in atypical... |
We report a case of septic arthritis due to H. influenzae associated with atypical Kawasaki disease. A 2-year-old boy was admitted to our orthopedic department due to limping gait of the right leg. CT finding of right hip joint revealed fluid collection. He was diagnosed as transient synovitis and septic arthritis. He was treated with antibiotics, but no incision nor... |
Kawasaki disease is a systemic vasculitis in which bilateral nonexudative conjunctivitis and anterior uveitis are common early findings in the course of illness. We report an eleven-year-old boy with atypical Kawasaki disease who was diagnosed with the help of an ophthalmologic examination. The patient presented with fever, epigastric pain with vomiting, erythematous rash, and severe bilateral conjunctival injection, a red... |
Purpose : To identify the risk factors for coronary sequelae in Kawasaki disease, we analyzed and compared the clinical features and laboratory findings of Kawasaki disease in patients younger than one year of age with those over one year of age. Methods : A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to the... |
Purpose : Gamma-globulin is effective in preventing coronary aneurysm, the primary complication of Kawasaki disease(KD). However, in order to predict high-risk cases which absolutely require γ-globulin, because of its high expenses, Harada score(HS) was introduced in Japan in 1990. We attempted to compare HS scoring with the health insurance criteria currently used in Korea. Methods : Retrospective studies were performed on... |
Percutaneous transluminal coronary angioplasty(PTCA) is rarely performed on patients with coronary arterial stenosis that resulted from Kawasaki disease. We experienced a 3 year 10-month- old male with a history of Kawasaki disease who developed a few numbers of fusiform aneurysm on the right and left coronary artery. We examined and followed up the patient for 21 months using eletrocardiography,... |
Purpose : Aspirin(acetylsalicylic acid) has been used to treat unstable angina and acute myocardial infarction in adults and Kawasaki disease in children. The antithrombotic effect of aspirin was attributed to its ability to inhibit platelet aggregation by inhibiting platelet cyclooxygenase, which leads to decreased thromboxane synthesis. The purpose of this study was to evaluate the effect on the platelet aggregation... |
Purpose : Myocardial scintigraphy has been reported to be useful in adults, but its usefulness in children is limited. This study was done to determine the feasibility and accuracy of 99mTc-MIBI SPECT(sestamibi, methoxy-isobutyl-isonitrarite myocardial single emission computed tomography, Dp-SPECT) after dipyridamole infusion to detect coronary obstructive lesions in Kawasaki disease (KD). Methods : Dp-SPECT was performed in 21 control(group 1), 8... |
Visualization of coronary collaterals in coronary arteriography performed in vivo constitutes an important finding, and particularly in the presence of coronary artery disease, it allows observations related to the hemodynamic consequences of the disease process. Undoubtedly, the presence of collateral flow indicates that a compensatory mechanism has developed to ameliorate the detrimental effect of blood flow cessation due to obstruction... |
Purpose : High dose intravenous immunoglobulin(IVIG) therapy is effective in reducing the incidence of coronary artery aneurysm in Kawasaki disease(KD) patients, however, the precise mechanisms by which IVIG reverses the immune activation is unknown. Methods : The sera and peripheral mononuclear cells(PBMCs) were obtained from 10 KD patients in the acute stage(24 hrs before) and 24 hrs after one dose of IVIG(2g/kg) treatment. We measured... |
Purpose : Antineutrophil cytoplasmic antibody(ANCA) has been identified in various disorders including Wegener' s granulomatosis, microscopic polyarteritis and Kawasaki disease. Measuring this antibody has a diagnostic role. It facilitates monitoring disease activity and may also help understand the pathogenesis of the diseases in which it is found. We investigated the correlation between the hematologic findings and ANCA in acute Kawasaki disease and the diagnostic potential... |
Purpose : The pathogensis and etiologic agents are still unknown but clinical studies suggest that Kawasaki disease(KD) is an autoimmune disease caused by infectious agents associated with the early development of acute myocarditis and coronary artery abnormalities. The study investigates serum troponin I(cTnI) and creatine kinase(CK)-MB in the acute stage of KD before diagnosis the use of intravenous immunoglobulin(IVIG) treatment... |
Purpose : We investigated what kind of factors are the most stable among hemoglobin(Hb), hematocrit(Hct), MCV, MCH and RDW as a marker of discriminating anemia due to an acute inflammation from anemia of different origins. Methods : We evaluated 141 patients with Kawasaki disease who had been admitted to the Department of Pediatrics, Inha hospital from 1990 to 1995. We... |
Purpose : Since the effect of intravenous immunoglobulin (IVIG) therapy in Kawasaki disease was reported in 1984, the combined therapy of IVIG & oral aspirin has been popular. In early period, the protocol of 400mg/kg/day for 3-5 days of IVIG had been used, but rescently, the protocol of 2g/kg/day single dose has been preferred. So authers performed a clinical study to compare th efficacies... |
Purpose : To evaluate the efficacy of steroid therapy on prevention of development and progression of coronary artery aneurysm in intravenous immune globulin(IVIG)-resistant Kawasaki disease, we treated three children with high dose of intravenous methylprednisolone followed by low dose oral prednisolone. Methods : We selected three children with Kawasaki disease who did not repond or who initially responded but soon developed recrudescent fever after retreatment... |
Kawasaki disease is an acute illness of early childhood, especially less than 5 years of age, characterized by prolonged fever(> 5 days), changes of lips and oral cavity, changes of peripheral extremities, polymorphous skin rash, bilateral conjunctival congestion and acute nonpurulent cervical lymphadenopathy. Usually, the recurrence of Kawasaki disease is not frequent. It is thought that the factors in recurrence of Kawasaki disease was... |
Purpose : The value of serum lipid in children after recovery of Kawasaki disease may be important because of the predilection of this disease for the coronary artery. Methods : We measured serum high density lipoprotein(HDL)-cholesterol, total cholesterol, triglycerides in 22 patients (mean age 38months, range 6 to 93 months) with Kawasaki disease during 10 days or less after onset and 2 months later... |
Purpose : We performed a study on clinical benefits of Harada's scoring method, problems of present criteria and requirement of the revision of that criteria for intrvenos γ-globulin(IVGG) treatment of Kawasaki disease(KD) in Korea. Methods : The patients of 104 cases who visited to Department of Pediatrics of Chungnam National University Hospital and diagnosed as KD were objective group. We classified the... |
Purpose : The etiology of the Kawasaki disease remains unclear, many strong clinical and epidemiologic characteristics suggest an infectious etiology. However, conventional bacterial and viral cultures and extensive serologic studies have not revealed a consistent causative agent. Thus we studied the Epstein Barr virus(EBV), one of the most important pathogens, to access the association between the EBV and Kawasaki disease. Methods : Seventy-two patients with... |
Purpose : The recurrence of Kawasaki disease has not been considered significant and has not been reported on literatures in Korea. Authors reviewed cases with recurrent Kawasaki disease to get informations about recurrent Kawasaki disease and to know whether there is any factor, if present, that can predict recurrence. Methods : We reviewed and analyzed the hospital records of patients with recurrent Kawasaki disease who... |
Purpose : Kawasaki disease(KD) is multi-systemic vasculitis and coronary artery abnormalities can develop up to 30 percent in untreated patients. Several observations suggest that immune activation and the secretion of cytokines from immune effector cells contribute to the pathogenesis of this disease. Though high dose intravenous gamma globulin(IVGG,>1 gm/kg) is effective in reducing the prevalence of coronary artery aneurysms in KD,... |
Purpose : There are some disagreements about the optimal dosages of intravenous gammaglobulin(IVGG) and oral aspirin(ASA) in the treatment of Kawasaki disease. So authors performed a prospective clinical study to evaluate the efficacy of IVGG 1g/kg plus ASA 50mg/kg/day. Methods : We treated 29 patients who were admitted to Inha University Hospital from June 1993 through May 1994 with IVGG 1g/kg plus ASA 50mg/kg/d. We... |
Purpose : It has been suggested that immunologic abnormalities play a role in the pathogenesis of vascular injury in Kawasaki disease and the immunologic abnormalities could be regulated by high-dose intravenous immunoglobulin(IVIG). We investigated the peripheral blood lymphocyte subsets, the serum levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) and the effect of high-dose IVIG(400 mg/kg/day for 5 days) on these factors during acute stage of... |
Purpose : Kawasaki disease (KD) is an acute febrile illness of infancy and early childhood characterized by diffuse vasculitis. Although the disease is generally self-limited, up to 25% of untreated patients with KD may develop coronary artery abnormalities. The acute phase of KD is characterized by marked activation of the immune system leading to increased cytokine production by immune effector... |
Kawasaki disease is an acute febrile illness of unknown etiology that occurs predominantly in infants and early childhood. It had aroused intense interest because of the sequelae of coronary arteritis accompanied by coronary artery aneurysms and thrombotic occlusion, which may lead to ischemic heart disease or sudden death. Atypical Kawasaki disease is coined to describe patients who have coronary abnormalities,... |
Kawasaki disease may be associatde with a variety of hematologic abnormalities, the most characteristic being thrombocytosis. Thrombocytopenia, in contrast, appears to occur rarely in children with this disease. Hera et al observed the 2% manifested thrombocytopenia early in their illness. To our knowledge, early thrombocytopenia has not been reported in other populations, We report the case of a children with... |
Purpose : To investigate the effect of Kawasaki disease on coronary arterial distensibility, we studied 14 patients with Kawasaki disease who had had coronary artery aneurysms(mean of 4.5years have elapsed after onset of Kawasaki disease). Methods : Using Hewiett Packard-1500 echocardiogram, we measured RR interval, BP(blood pressure), EDD(end diastolic dimension), ESD(end systolic dimension), FS(fractional shortening), LVPWT(left ventricular posterior wall thickness), peak... |
Purpose : This study was performed to investigate the clinical characteristics in Kawasaki meningitis and viral meningitis. Methods : A clinical observation and comparison were carried out on 37 patients of Kawasaki disease with meningitis(group A) and 28 patients of Kawasaki disease without meningitis (group B) who were admitted to Catholic Medical Center from July, 1991 to June, 1993 and 100... |
Purpose : A prospective study was performed to evaluate the efficacies of two different dosages of aspirin(ASA) in treating Kawasaki disease(KD). Methods : Thirty-nine children with KD were admitted to this hospital from July, 1992 to May, 1993, and were assigned randomly into 2 groups. Group A(medium-dose group, 20 patients) was given 50mg/kg/d(# 4), and group B(high-dose gorup, 19 patients) was... |
Patients with atypical or incomplete Kawasaki disease are at same risk for development of coronary artery complications as typical Kawasaki disease. In this communication we report six patients with unusual presentation of Kawasaki disease complicated by coronary artery aneurysms, in whom correct diagnosis were not made in time for proper treatment. One of these patients died from massive myocardial ischemia... |