PMID- 32219919
OWN - NLM
STAT- MEDLINE
DCOM- 20210316
LR  - 20210316
IS  - 1442-200X (Electronic)
IS  - 1328-8067 (Linking)
VI  - 62
IP  - 7
DP  - 2020 Jul
TI  - Treatment change and coronary artery abnormality in incomplete Kawasaki disease.
PG  - 779-784
LID - 10.1111/ped.14242 [doi]
AB  - BACKGROUND: Incomplete Kawasaki disease (iKD) showed a higher incidence of 
      coronary artery abnormalities (CAAs) than complete KD. However, the incidence of 
      CAAs among iKD patients may have changed recently. METHODS: We examined KD 
      patients from recent nationwide surveys conducted between 2013 and 2016 and 
      compared them with the results of a previous survey (2001-2002). RESULTS: Of 
      63 270 KD patients, 13 770 patients (22%) had iKD. They showed a higher incidence 
      of convalescent-phase CAAs (cCAAs, 2.8%) than complete KD (2.1%). The incidence 
      of cCAAs in patients with one or two symptoms (6.7%) was significantly higher 
      than those with three or four symptoms (2.6%) (P < 0.0001). Intravenous 
      immunoglobulin (IVIG) treatment was administered to 80% of iKD patients; 30% of 
      them received IVIG before the fifth illness day (early treatment) and 12% of 
      patients received IVIG after the seventh illness day (late treatment). In the 
      previous survey, the incidence of cCAAs was higher in both iKD (5.9%) and cKD 
      (4.4%). Intravenous immunoglobulin was administered to 62% of iKD patients; 26% 
      of them received early treatment, and 16% received late treatment. CONCLUSIONS: 
      The incidence of cCAAs remained higher among iKD patients than cKD patients but 
      this difference was reduced by the increased proportion of iKD patients treated 
      with IVIG and those at an earlier time point. It is important to recognize the 
      possibility that patients may have iKD and perform echocardiography even if they 
      present with a few principal symptoms.
CI  - (c) 2020 Japan Pediatric Society.
FAU - Nomura, Yuichi
AU  - Nomura Y
AUID- ORCID: 0000-0001-7381-410X
AD  - Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan.
FAU - Yashiro, Mayumi
AU  - Yashiro M
AD  - Department of Public Health, Jichi Medical University, Tochigi, Japan.
FAU - Masuda, Kiminori
AU  - Masuda K
AD  - Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan.
FAU - Nakamura, Yoshikazu
AU  - Nakamura Y
AD  - Department of Public Health, Jichi Medical University, Tochigi, Japan.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Pediatr Int
JT  - Pediatrics international : official journal of the Japan Pediatric Society
JID - 100886002
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Coronary Artery Disease/epidemiology
MH  - Coronary Vessel Anomalies/diagnosis/*epidemiology
MH  - Echocardiography/methods
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage
MH  - Immunologic Factors/administration & dosage
MH  - Incidence
MH  - Infant
MH  - Male
MH  - Mucocutaneous Lymph Node Syndrome/*epidemiology/*therapy
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Kawasaki disease
OT  - coronary artery abnormality
OT  - incomplete Kawasaki disease
OT  - intravenous immunoglobulin treatment
OT  - principal symptom
EDAT- 2020/03/29 06:00
MHDA- 2021/03/17 06:00
CRDT- 2020/03/29 06:00
PHST- 2019/11/21 00:00 [received]
PHST- 2020/03/17 00:00 [revised]
PHST- 2020/03/19 00:00 [accepted]
PHST- 2020/03/29 06:00 [pubmed]
PHST- 2021/03/17 06:00 [medline]
PHST- 2020/03/29 06:00 [entrez]
AID - 10.1111/ped.14242 [doi]
PST - ppublish
SO  - Pediatr Int. 2020 Jul;62(7):779-784. doi: 10.1111/ped.14242.