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1.
Arch. argent. pediatr ; 119(4): S198-S211, agosto 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281043

ABSTRACT

La pandemia ocasionada por el nuevo coronavirus (SARS-CoV-2), declarada por la Organización Mundial de la Salud OMS) en marzo de 2020, afecta a un reducido número de pacientes pediátricos, quienes presentan, en su mayoría, compromiso respiratorio leve y evolución favorable. Sin embargo, en niños previamente sanos, comenzó a observarse un aumento de casos definidos como síndrome inflamatorio multisistémico (SIM-C) o similar a Kawasaki (Kawasaki-like) asociado a la enfermedad por el nuevo coronavirus (COVID-19) (KL-C) que evolucionan al shock y requieren internación en la unidad de cuidados intensivos.Los cuadros de SIM-C y los KL-C se caracterizan por fiebre, signos de inflamación, síntomas gastrointestinales y disfunción cardiovascular; las formas graves de presentación tienen mayor incidencia de hipotensión y/o shock. En el laboratorio se observan marcadores de inflamación, hipercoagulabilidad y daño miocárdico. El tratamiento farmacológico de primera línea consiste en la administración de inmunoglobulina por vía intravenosa más ácido acetilsalicílico por vía oral.Se recomienda un abordaje multidisciplinario para un diagnóstico certero y un tratamiento temprano y eficaz para disminuir la morbimortalidad.


The pandemic caused by the SARS-CoV-2 virus declared by the WHO in March 11th 2020, affects a small number of pediatric patients, who mostly present mild respiratory compromise and favorable evolution.However began to be observed in previously healthy children, an increase in cases defined as "Multisystemic Inflammatory Syndrome" (MIS-C) or "Kawasaki-like" post-COVID 19 (KL-C) that evolve to shock and require hospitalization in the Pediatric Intensive Care Unit.MIS-C and KL-C are characterized by fever; signs of inflammation, gastrointestinal symptoms, and cardiovascular dysfunction, associated with sever forms of presentation with higher incidence of hypotension and/or shock. In the laboratory, markers of inflammation, hypercoagulability and myocardial damage are observed. First-line drug treatment consists of intravenous immunoglobulin plus oral acetylsalicylic acid.A multidisciplinary approach is recommended for an accurate diagnosis and an early and effective treatment, in order to reduce morbidity and mortality.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Systemic Inflammatory Response Syndrome/therapy , COVID-19/therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Immunoglobulins, Intravenous/therapeutic use , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/diagnosis , Critical Care , Diagnosis, Differential , COVID-19/complications , COVID-19/diagnosis , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/therapy
2.
Rev. colomb. cardiol ; 28(2): 175-179, mar.-abr. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341280

ABSTRACT

Resumen La enfermedad de Kawasaki es un síndrome febril agudo y autolimitado, de presunta etiología autoinmune, que característicamente afecta a niños menores de 5 años. Esta enfermedad consiste en una vasculitis aguda de pequeños y medianos vasos que favorece la formación de aneurismas en las arterias coronarias. El diagnóstico en la fase aguda es esencialmente clínico, mientras que en la fase crónica suele hacerse al documentar las secuelas vasculares. La importancia de la identificación apropiada de esta enfermedad radica en que muchos de los infartos fatales y no fatales en personas menores de 40 años tienen hallazgos compatibles con este diagnóstico. Se presenta el caso de un adulto joven con dolor torácico y angiotomografía coronaria con hallazgos compatibles con secuelas de enfermedad de Kawasaki del adulto.


Abstract Kawasaki disease is an acute and self-limited febrile syndrome with a presumed autoimmune etiology that characteristically affects children under 5 years of age. Kawasaki disease is an acute vasculitis of small and medium vessels that facilitates the formation of coronary aneurysms. The diagnosis of the disease during the acute phase is essentially clinical, while the diagnosis of Kawasaki disease during the chronic phase is performed when the vascular complications are detected. The importance of proper identification of Kawasaki disease lies in the fact that many of the fatal and non-fatal infarcts in young adults (<40 years) have findings compatible with this diagnosis. This article describes the case of a young patient with chest pain and coronary angiotomography showing sequelae of Kawasaki disease in the adult.


Subject(s)
Humans , Male , Adult , Coronary Aneurysm , Chest Pain , Computed Tomography Angiography , Mucocutaneous Lymph Node Syndrome
3.
Bol. méd. postgrado ; 37(1): 27-33, Ene-Jun 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147875

ABSTRACT

Se realizó una investigación descriptiva transversal retrospectiva con el fin de determinar el perfil clínico y epidemiológico de la enfermedad de Kawasaki (EK) en 95 niños egresados del Hospital Pediátrico Dr. Agustín Zubillaga durante el período 2014-2017. El promedio de edad de los pacientes se ubicó en 3,9 ± 3,3 años, siendo 69,5% del sexo masculino. El tiempo de evolución de la enfermedad fue menor de 10 días en el 68,4% de los casos. Las manifestaciones clínicas predominantes fueron fiebre (100%), edema y/o descamación de palmas y plantas (85,3%), alteración de la mucosa oral (65,3%), inyección conjuntival (59%) y eritema polimorfo (55,8%). El tratamiento recibido consistió en aspirina (100%) e inmunoglobulina (96,8%). La respuesta al tratamiento fue satisfactoria en el 95,8% de los pacientes. Los hallazgos de laboratorio evidenciaron una PCR elevada (51,6%) y trombocitosis (97,9%) con hemoglobina normal en 62,1% de los casos. 41% de los pacientes presentaron ecocardiograma anormal y 97,9% presentaron ultrasonido abdominal normal. El diagnóstico de ingreso de la EK fue incompleto en 53,7% de los pacientes y el diagnóstico de egreso de la EK fue completo en 51,6%. Los resultados de este estudio brindan datos epidemiológicos recientes sobre la enfermedad de Kawasaki en nuestra institución prestadora de salud(AU)


A descriptive cross-sectional retrospective investigation was carried out to evaluate the clinical and epidemiological profile of Kawasaki disease (KD) in 95 children discharged from the Pediatric Hospital Dr. Agustín Zubillaga during the period 2014-2017. Mean age of children was 3.9 ± 3.3 years and 69.5% were male. Time of symptom onset was less than ten days in 68.4% patients. Predominant clinical manifestations were fever (100%), edema and/or desquamation of palms and soles (85.3%), alteration of the oral mucosa (65.3%), conjunctival injection (59%) and polymorphic erythema (55.8%). Treatment received included aspirin (100%) and immunoglobulin (96.8%). Response to treatment was satisfactory in 95.8% of cases. Laboratory findings showed elevated CRP (51.6%), thrombocytosis (97.9%) and normal hemoglobin in 62.1% patients. 41% had an abnormal echocardiogram and 97.9% showed a normal abdominal ultrasound. The diagnosis of CHD admission was incomplete in 53.7% of cases and the diagnosis of EK was complete in 51.6%. Results of this study show recent epidemiological data about Kawasaki disease in our healthcare institution(AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Immunoglobulins/therapeutic use , Aspirin/therapeutic use , Clinical Laboratory Techniques , Coronary Disease/etiology , Mucocutaneous Lymph Node Syndrome/epidemiology , Signs and Symptoms , Vasculitis , Edema , Fever
4.
Article in English | AIM | ID: biblio-1293232

ABSTRACT

Kawasaki disease (KD) is a self-limiting, acute febrile vasculitis with predilection for children under-5 years. Most reports have emanated from Japan with only a few cases reported in Africa. KD presents a diagnostic dilemma and a high index of suspicion is critical as early treatment reduces the incidence of complications. We describe a 5-month-old male infant who presented with classical clinical features though with delayed diagnosis. Received moderate dose aspirin with limitation of access to intravenous immunoglobulin and who did not develop coronary artery complication. The case report highlights the diagnostic challenges faced by practitioners, made worse by the low index of suspicion inherent in our setting. The fatal complications that may be associated with KD can, therefore, be avoided. It is hoped that pediatricians in particular would become conversant with the diagnostic criteria to facilitate early diagnosis and intervention in children


Subject(s)
Humans , Obstetric Labor Complications , Mucocutaneous Lymph Node Syndrome , Child , Coronary Vessels , Nigeria
5.
Article in Chinese | WPRIM | ID: wpr-879836

ABSTRACT

Kawasaki disease is the main cause of acquired heart disease in children. The cardiovascular sequelae of Kawasaki disease, such as coronary artery lesion and giant coronary aneurysm, have a great impact on children's physical and mental health. The Japanese Circulatory Society and the Japanese Society of Cardiac Surgery jointly released the JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease in July, 2020, which systematically introduces the advances in the diagnosis and management of cardiovascular sequelae of Kawasaki disease. The article gives an interpretation in the severity evaluation of Kawasaki disease and diagnosis, treatment and long-term management of cardiovascular sequelae in the guideline.


Subject(s)
Child , Coronary Aneurysm , Coronary Vessels , Disease Progression , Heart Diseases , Humans , Mucocutaneous Lymph Node Syndrome/therapy
6.
Braz. j. med. biol. res ; 54(3): e10281, 2021. tab
Article in English | LILACS | ID: biblio-1153528

ABSTRACT

This study aimed to examine and summarize clinical characteristics of Kawasaki disease (KD) at different ages to further strengthen clinicians understanding of children with KD, improving the level of diagnosis, and reducing coronary artery complications of KD. A total of 398 patients with KD who were diagnosed between January 2016 and December 2017 were reviewed retrospectively. These participants were allocated into three groups according to age: group A (<1 year, n=62), group B (≥1 and <5 years, n=286), and group C (≥5 years, n=50). Clinical manifestations, laboratory results, and echocardiographic findings were compared among the groups. Most (71.86%) patients with KD were aged 1-5 years. The prevalence of cervical lymphadenopathy was lowest in group A. The duration of fever before admission was longest in group A. The rate of cervical lymphadenopathy and laboratory data were different among the groups. Group A had higher frequencies of gastrointestinal involvement, neurological symptoms, and redness at the Bacillus Calmette-Guerin inoculation site than the other groups. Infants aged <1 year with KD often have a longer duration of fever before admission, a lower prevalence of cervical lymphadenopathy, and a higher prevalence of gastrointestinal and neurological symptoms.


Subject(s)
Humans , Infant , Child, Preschool , Child , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/epidemiology , Time Factors , Retrospective Studies , Age Distribution , Coronary Vessels
7.
Braz. oral res. (Online) ; 35: e047, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1153608

ABSTRACT

Abstract: Kawasaki disease (KD) is a vasculitis with predilection for coronary arteries. Due to a lack of reliable confirmatory laboratory tests, the diagnosis of KD is based on a characteristic pattern of clinical findings that appear in a typical temporal sequence. The diagnostic criteria have been periodically modified and the American Heart Association has proposed the most recent guidelines for its diagnosis. However, patients may have incomplete or atypical forms of KD and diagnosis can often be difficult. Because oropharyngeal manifestations are a common and important feature for diagnosing KD and recent studies have hypothesized a possible association between KD and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in this review we highlight the importance of dentists in the diagnosis of KD and its potential association with SARS-CoV-2.


Subject(s)
Humans , COVID-19 , Mucocutaneous Lymph Node Syndrome/diagnosis , United States , Dentists , SARS-CoV-2
10.
Rev. chil. infectol ; 37(5): 584-590, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144255

ABSTRACT

Resumen Antecedentes: La enfermedad de Kawasaki (EK) en lactantes bajo un año de edad es poco frecuente en la mayoría de los países. Este grupo de pacientes tienen mayor riesgo de desarrollar complicaciones cardiacas. Objetivo: Evaluar el comportamiento clínico, tratamiento empleado y pronóstico cardiaco en lactantes bajo un año de edad atendidos por EK en un hospital pediátrico de tercer nivel en la Ciudad de México. Pacientes y Métodos: Estudio retrospectivo, descriptivo, de pacientes con diagnóstico de EK desde agosto de 1995 a agosto de 2019. Se estudió la presentación clínica, los exámenes de laboratorio, el tratamiento administrado y el desarrollo de lesiones coronarias en pacientes bajo un año de edad y se comparó con pacientes mayores. Resultados: Se estudiaron 687 pacientes, 152 de ellos eran lactantes bajo un año de edad (22,1%). Hubo un mayor tiempo al diagnóstico de la EK en los lactantes menores, con un incremento de presentaciones clínicas incompletas; este grupo de pacientes desarrolló en forma más frecuente lesiones coronarias en comparación con los pacientes mayores y también tuvo un mayor porcentaje de aneurismas coronarios gigantes. Hubo dos fallecimientos en los lactantes menores, secundarios a infarto al miocardio. Conclusiones: El diagnóstico de EK en pacientes bajo un año de edad es un reto diagnóstico con presentaciones clínicas incompletas y mayor riesgo de desarrollar complicaciones cardiacas graves.


Abstract Background: Frequency of Kawasaki disease (KD) in infants is low in almost all countries. These patients are at higher risk of developing cardiac complications. Aim: To evaluate the clinical features, treatment used and cardiac outcome in infants under one year of age attending for KD in a third level pediatric hospital in Mexico City, Mexico. Methods: A cross-sectional study was conducted in our hospital from August 1995 to August 2019. We analyzed the clinical features, laboratory results, treatment used and cardiac outcomes in infants younger than one year of age and compared them with older patients. Results: We included 687 patients, 152 were younger than one year of age (22.1%). There was a delayed diagnosis in younger patients with an increased frequency of incomplete clinical presentations. Coronary artery abnormalities were most common in younger infants who also had an increased frequency of giant coronary artery aneurysms. Two patients in the younger group died in the acute phase of KD of myocardial infarction. Conclusions: Diagnosis of KD in infants younger than 1 year of age is a clinical challenge with an increased rate of incomplete clinical presentations and also an increased risk of development of severe cardiac complications.


Subject(s)
Humans , Infant , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/epidemiology , Cross-Sectional Studies , Retrospective Studies , Hospitals , Mexico/epidemiology
11.
Arch. argent. pediatr ; 118(5): 327-331, oct 2020. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1122024

ABSTRACT

Introducción. La enfermedad de Kawasaki (EK) es una vasculitis sistémica inespecífica que suele presentarse en los niños; la lesión de las arterias coronarias (LAC) es la complicación más grave.Objetivos. Nuestro objetivo fue investigar los factores de riesgo de LAC en niños con EK.Materiales y métodos. Se incluyó a niños con EK según los criterios diagnósticos, hospitalizados entre enero de 2014 y diciembre de 2017. Se realizaron análisis univariado y multivariado de regresión logística para investigar las relaciones entre LAC y género, edad, diagnóstico clínico, velocidad de sedimentación globular (VSG), recuento de trombocitos, concentración de hemoglobina, concentración de proteína C-reactiva, recuento de leucocitos, momento de inicio de la administración de inmunoglobulina intravenosa (IgIV) y duración de la fiebre.Resultados. Se dividió a los 982 niños con EK en un grupo con LAC (n = 104) y otro sin LAC (n = 878), según una ecocardiografía Doppler color. La tasa de incidencia de LAC fue del 10,6 % (104/982). En el análisis univariado, se observó una diferencia significativa entre ambos grupos en cuanto al género, la VSG, el recuento de trombocitos, el momento de inicio de la administración de IgIV y la duración de la fiebre (p < 0,05). Según el análisis multivariado de regresión logística, el sexo masculino, una VSG elevada y la administración tardía de IgIV fueron factores de riesgo independientes de EK complicada con LAC.Conclusiones. El sexo masculino, una VSG elevada y la administración tardía de IgIV fueron factores de riesgo independientes de EK complicada con LAC.


Introduction. Kawasaki disease (KD) is a non-specific systemic vasculitic disease that frequently occurs among children, and coronary artery lesion (CAL) is the most serious complication.Objectives. We aimed to study the risk factors for CAL in children with KD.Materials and methods. KD children in accordance with diagnostic criteria, who were hospitalized from January 2014 to December 2017, were selected as subjects. Univariate and multivariate logistic regression analyses were conducted to explore the relationships between CAL and gender, age, clinical diagnosis, erythrocyte sedimentation rate (ESR), platelet count, hemoglobin level, C reactive protein level, white blood cell count, initiation time of IVIG administration and duration of fever.Results. The enrolled 982 KD children were divided into a CAL group (n = 104) and an NCAL group (n = 878) according to cardiac color Doppler ultrasonography. The incidence rate of CAL was 10.6 % (104/982). Univariate analysis showed that the two groups had significantly different gender, ESR, platelet count, initiation time of IVIG administration and duration of fever (P < 0.05). Multivariate logistic regression analysis revealed that male gender, elevated ESR and delayed use of IVIG were independent risk factors for KD complicated with CAL.Conclusions:Male gender, increased ESR and delayed use of IVIG were independent risk factors for KD complicated with CA


Subject(s)
Humans , Male , Female , Child , Coronary Artery Disease/epidemiology , Mucocutaneous Lymph Node Syndrome/complications , Logistic Models , Statistical Analysis , Risk Factors , Coronary Vessels/injuries , Mucocutaneous Lymph Node Syndrome/diagnosis
12.
Acta pediátr. hondu ; 11(1): 1129-1135, abr.- sept. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1140560

ABSTRACT

La Enfermedad de Kawasaki (EK) o Síndrome de Kawasaki, es una enfermedad febril aguda, de etiología desconocida, que afecta mayormen-te a población pediátrica menor de 5 años y es una causa común de patología cardíaca en estos grupos etarios. Su diagnóstico es definido por la presencia de ciertos criterios clínicos caracterís-ticos como fiebre persistente de al menos 5 días de evolución, linfadenopatías cervicales unila-terales, inyección conjuntival, alteraciones en la mucosa oral, edema en extremidades y como parte de las complicaciones severas que pue-de presentar, se incluyen la formación de aneu-rismas en las arterias coronarias, entre otros.Actualmente, el mundo se ha detenido por la aparición del nuevo SARS CoV-2 (Covid-19), que se ha dado a conocer por sus efectos de-vastadores, tanto por sus abundantes pérdidas humanas y su enorme golpe en las diferentes economías mundiales. Ya es conocida la rela-ción de otros coronavirus humanos que se han vinculado con la EK, sin embargo es de recien-te aparición, algunos reportes de casos en va-rios países, que vinculan pacientes pediátricos que cumplen criterios de EK con la infección confirmada de SARS CoV-2.En el presente es-crito, se describirá la posible vinculación de éste nuevo virus con la Enfermedad de Kawasaki...(AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Coronavirus Infections/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Vasculitis/diagnosis , Severe Acute Respiratory Syndrome
13.
Rev. bras. cir. cardiovasc ; 35(4): 539-548, July-Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137283

ABSTRACT

Abstract Objective: To examine the results of various myocardial revascularization techniques in pediatric patients to better understand the strategies for surgical treatment of coronary artery pathologies. Methods: We analyzed 61 publications dedicated to the indications, methods, and results of coronary bypass surgery in children. Due to the small size of this cohort, case reports are also included in our review. Results: The main indications for coronary bypass grafting in children are Kawasaki disease, myocardial revascularization as a necessary procedure during the congenital cardiac surgery, to manage intraoperative iatrogenic damage to coronary arteries, and homozygous familial hypercholesterolemia. The use of internal thoracic arteries as conduits for coronary bypass grafting in children with Kawasaki disease showed significantly better results in long-term functionality compared to autovenous conduits (87% and 44%, respectively, P<0.001). Acute and late coronary events after arterial switch operation for the transposition of the great arteries, anomalous origin of the left coronary artery from the pulmonary artery, and left main coronary artery atresia are the main congenital heart diseases where surgical correction involves interventions on the coronary arteries. Conclusion: The internal thoracic artery is a reliable and durable conduit that demonstrates proven growth potential in children.


Subject(s)
Humans , Infant , Child, Preschool , Child , Transposition of Great Vessels , Coronary Artery Bypass , Mammary Arteries/surgery , Retrospective Studies , Coronary Vessels , Mucocutaneous Lymph Node Syndrome/surgery
14.
Rev. pediatr. electrón ; 17(1): 1-7, abr 2020.
Article in Spanish | LILACS | ID: biblio-1099830

ABSTRACT

La enfermedad de Kawasaki (EK) es una vasculitis aguda de vaso mediano que afecta principalmente a niños menores de 5 años, que de no ser tratada, se asocia al desarrollo de aneurismas de las arterias coronarias en aproximadamente el 25% de los casos. Típicamente la EK se presenta con fiebre, cambios mucocutáneos y linfadenopatía. Sin embargo, EK es una enfermedad excepcional en la que las formas incompletas de la enfermedad son muy comunes y a menudo asociación sintomatologías atípicas. Éstas pueden crear un desafío diagnóstico para los tratantes y retrasar el inicio de la terapia. No existe un gold standard para el diagnóstico de EK pero hay estudios de laboratorio y hallazgos ecocardiográficos que permiten apoyar el diagnóstico en casos incompletos. El estudio con ecocardiograma debe realizarse lo más pronto posible cuando se sospecha el diagnóstico, pero no debe retrasar el inicio de tratamiento. El objetivo de la terapia en EK es disminuir el riesgo de desarrollar aneurismas de las arterias coronarias y de esta forma, la morbimortalidad asociada a dicha condición. El propósito de esta revisión es conocer las características clínicas y las posibles formas de presentación de esta patología, además del tratamiento actual.


Kawasaki disease (KD) is an acute vasculitis of the medium vessel that mainly affects children under 5 years old, which if it's not treated, is associated with the development of coronary artery aneurysms in approximately 25% of all cases. Typically, KD presents with fever, mucocutaneous changes and lymphadenopathy. However, EK is an exceptional disease in which incomplete forms of the disease are very common and atypical presentations often occur. These presentations may create a diagnostic puzzle for pediatricians and may delay the start of therapy. There is no specific study for the diagnosis of KD but there are laboratory studies and findings in ECG that support the diagnosis in atypical cases. The echocardiogram study should be performed as soon as possible when the diagnosis is suspected, but should not delay the treatment. The goal of treatment in KD is to reduce the risk of developing aneurysms of the coronary arteries and thereby decrease the morbidity and mortality associated with this condition.


Subject(s)
Humans , Infant , Child, Preschool , Child , Mucocutaneous Lymph Node Syndrome/diagnosis , Echocardiography , Mucocutaneous Lymph Node Syndrome/etiology , Mucocutaneous Lymph Node Syndrome/therapy
15.
Article in Chinese | WPRIM | ID: wpr-828697

ABSTRACT

OBJECTIVE@#To study the association of the polymorphisms of the serum amyloid A1 (SAA1) gene at rs4638289 and rs7131332 loci with Kawasaki disease (KD) and its complication coronary artery lesion (CAL) in children.@*METHODS@#A total of 105 Han children with KD who were hospitalized and treated from 2013 to 2017 were enrolled as the KD group. A total of 100 Han children who underwent physical examination were enrolled as the control group. According to the presence or absence of CAL, the KD group was further divided into a CAL group with 23 children and a non-CAL (NCAL) group with 82 children. Polymerase chain reaction-restriction fragment length polymorphism was used to investigate the polymorphisms of the SAA1 gene at rs4638289 and rs7131332 loci.@*RESUKTS@#For the locus rs4638289 of the SAA1 gene, there were no significant differences between the KD and control groups in the genotype frequencies of AA, AT, and TT and the allele frequencies of A and T (P>0.05). But there were significant differences between the CAL and NCAL groups in the genotype frequencies of AA, AT, and TT (P=0.016), while there were no significant differences in the allele frequencies of A and T (P>0.05). AT genotype was a protective factor against CAL (OR=0.276, 95%CI: 0.099-0.772, P=0.011). For the locus rs7131332 of the SAA1 gene, there were no significant differences between the KD and control groups in the genotype frequencies of AA, AG, and GG and the allele frequencies of A and G (P>0.05). There were also no significant differences between the CAL and NCAL groups in the genotype frequencies of AA, AG, and GG and the allele frequencies of A and G (P>0.05).@*CONCLUSIONS@#Polymorphisms of the SAA1 gene at loci rs4638289 and rs7131332 are not associated with the onset of KD, while the polymorphism at the locus rs4638289 is associated with CAL in KD patients. KD patients with genotype AT may have a reduced risk of CAL.


Subject(s)
Case-Control Studies , Child , Gene Frequency , Genetic Predisposition to Disease , Genotype , Humans , Mucocutaneous Lymph Node Syndrome , Genetics , Polymorphism, Restriction Fragment Length , Polymorphism, Single Nucleotide , Serum Amyloid A Protein , Genetics
16.
Article in Chinese | WPRIM | ID: wpr-828686

ABSTRACT

Since the outbreak of coronavirus disease 2019 (COVID-19) in Europe and America, the incidence of Kawasaki disease has significantly increased, which has aroused concern among pediatricians and parents. COVID-19 can cause inflammation reactions of multiple organs, which is similar to the systemic vasculitis of Kawasaki disease, and even COVID-19 can cause skin rash on the extremities of the limbs, which is also similar to Kawasaki disease. The cause of Kawasaki disease is currently unclear, and it cannot be ruled out that COVID-19 is associated with an increased incidence of Kawasaki disease. Therefore, during the epidemic of COVID-19, if children have symptoms similar to Kawasaki disease, intravenous immunoglobulin is recommended as early as possible to reduce the incidence of coronary artery lesions.


Subject(s)
Betacoronavirus , Child , Coronavirus Infections , Humans , Mucocutaneous Lymph Node Syndrome , Pandemics , Pneumonia, Viral
17.
Article in Chinese | WPRIM | ID: wpr-828664

ABSTRACT

OBJECTIVE@#To study the biomarkers for human coronary artery endothelial cell (HCAEC) injury induced by Kawasaki disease (KD) using isobaric tags for relative and absolute quantitation (iTRAQ) proteomics.@*METHODS@#HCAECs cultured with the serum of children with KD were used as the KD group, and those cultured with the serum of healthy children was used as the healthy control group. The iTRAQ technique was used to measure the expression of proteins in two groups. The data on proteins were analyzed by bioinformatics. Western blot was used for the validation of protein markers.@*RESULTS@#A total of 518 significantly differentially expressed proteins were identified (with an absolute value of difference fold of >1.2, P<0.05). The gene ontology analysis showed that the differentially expressed proteins were significantly enriched in biological processes (including cellular processes, metabolic processes, and biological regulation), cellular components (including cell parts, cells, and organelles), and molecular functions (including binding, catalytic activity, and molecular function regulators). The KEGG analysis showed that the proteins were significantly enriched in the signaling pathways of ribosomes, PI3K-Akt signaling pathway, and transcriptional dysregulation in cancer. The PPI network showed that the top 9 protein markers in relation density were PWP2, MCM4, MCM7, MCM5, MCM3, MCM2, SLD5, HDAC2, and MCM6, which were selected as the protein markers for coronary endothelial injury in KD. Western blot showed that the KD group had significantly lower expression levels of the protein markers HDAC2, PWP2, and MCM2 than the healthy control group (P<0.05).@*CONCLUSIONS@#The serum of children with KD significantly changes the protein expression pattern of HCAECs and affects the signaling pathways associated with the cardiovascular system, which provides a new basis for the pathophysiological mechanism and therapeutic targets of KD.


Subject(s)
Child , Computational Biology , Coronary Vessels , Endothelial Cells , Humans , Mucocutaneous Lymph Node Syndrome , Phosphatidylinositol 3-Kinases , Proteomics
18.
Article in Chinese | WPRIM | ID: wpr-828625

ABSTRACT

OBJECTIVE@#To study the effect and related signaling pathways of ginsenoside Rb1 in the treatment of coronary artery lesion (CAL) in a mouse model of Kawasaki disease (KD).@*METHODS@#BALB/c mice were randomly divided into a control group, a model group, an aspirin group, a low-dose ginsenoside Rb1 group (50 mg/kg), and a high-dose ginsenoside Rb1 group (100 mg/kg), with 12 mice in each group. All mice except those in the control group were given intermittent intraperitoneal injection of 10% bovine serum albumin to establish a mouse model of KD. The mice in the aspirin group, the low-dose ginsenoside Rb1 group, and the high-dose ginsenoside Rb1 group were given the corresponding drug by gavage for 20 days after modeling. Hematoxylin and eosin staining was used to observe the pathological changes of coronary artery tissue. ELISA was used to measure the levels of the inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) in serum and coronary artery tissue. Western blot was used to measure the relative expression levels of proteins involved in the regulation of the AMPK/mTOR autophagy signaling pathway and the PI3K/Akt oxidative stress signaling pathway in coronary artery tissue.@*RESULTS@#The observation of pathological sections showed that compared with the model group, the high-dose ginsenoside Rb1 group had significant improvement in the symptoms of vascular wall thickening, intimal edema, fiber rupture, and inflammatory infiltration of endothelial cells. Compared with the control group, the model and low-dose ginsenoside Rb1 groups had significant increases in the levels of TNF-α, IL-6, and IL-1β in serum and coronary artery tissue (P0.05) and had significant increases in the expression levels of P-AKT/AKT and P-GSK-3β/GSK-3β (P<0.05), while the high-dose ginsenoside Rb1 group had significant increases in the relative protein expression levels of the above three proteins (P<0.05). Compared with the low-dose ginsenoside Rb1 group, the aspirin group and the high-dose ginsenoside Rb1 group had significant reductions in the levels of TNF-α, IL-6, and IL-1β (P<0.05); the high-dose ginsenoside Rb1 group had significant increases in the expression levels of P-PI3K/PI3K and P-AKT/AKT (P<0.05).@*CONCLUSIONS@#Ginsenoside Rb1 can effectively alleviate CAL in a mouse model of KD in a dose-dependent manner, possibly by regulating the AMPK/mTOR/P70S6 autophagy signaling pathway to inhibit CAL inflammation and regulating the PI3K/AKT/GSK-3β oxidative stress signaling pathway to exert a biological activity of protection against coronary artery endothelial cell injury.


Subject(s)
Animals , Coronary Vessels , Endothelial Cells , Ginsenosides , Glycogen Synthase Kinase 3 beta , Mice , Mice, Inbred BALB C , Mucocutaneous Lymph Node Syndrome , Phosphatidylinositol 3-Kinases , Proto-Oncogene Proteins c-akt
19.
Article in English | WPRIM | ID: wpr-827369

ABSTRACT

OBJECTIVES@#To provide clues for further study of the relationship between miRNAs and Kawasaki disease (KD) development, and to provide molecular markers for ultimately improve the rate of early diagnosis for KD.@*METHODS@#We collected acute, recovery KD children's plasma and normal samples, then used the miRNAs Assay Chip to screen the differentially expressed miRNAs in the plasma from KD children. Subsequently, miR-455-5p, which had identified via miRNAs assay chip, was validated by quantitative real-time PCR via independent cohort.@*RESULTS@#According to the results of miRNAs Assay chip, we identified a miRNAs panel including 5 miRNAs significantly up-regulated and 5 miRNAs remarkably down-regulated in the plasma from KD children compared to the normal control; miR-455-5p in both of acute and recovery KD children's plasma was remarkably lower than that in the normal control (<0.001, =0.013, respectively), and miR-455-5p was also significantly lower than that in the recovery of KD children (=0.007) by independent cohort validation.@*CONCLUSIONS@#There are significantly differentially expressed circulating miRNAs between the KD children and normal control. We identified 10 miRNAs dysregulation in the KD children's plasma compared with the normal group. Circulating miR-455-5p in both of acute and recovery KD children's plasma is remarkably lower than that in the normal control, and miR-455-5p may considered as a marker to show the recovery process of KD children. Plasma specific circulating miRNAs play an important role in the early diagnosis of KD and become the new molecular marker of KD in the future.


Subject(s)
Biomarkers , Child , Humans , MicroRNAs , Genetics , Mucocutaneous Lymph Node Syndrome , Genetics , Oligonucleotide Array Sequence Analysis , Real-Time Polymerase Chain Reaction
20.
Korean Circulation Journal ; : 112-119, 2020.
Article in English | WPRIM | ID: wpr-786228

ABSTRACT

Kawasaki disease is a form of vasculitis, mainly in small and medium arteries of unknown origin, occurring frequently in childhood. It is the leading form of childhood-onset acquired heart disease in developed countries and leads to complications of coronary artery aneurysms in approximately 25% of cases if left untreated. Although more than half a century has passed since Professor Tomisaku Kawasaki's first report in 1957, the cause is not yet clear. Currently, intravenous immunoglobulin therapy has been established as the standard treatment for Kawasaki disease. Various treatment strategies are still being studied under the slogan, “Ending powerful inflammation in the acute phase as early as possible and minimizing the incidence of coronary artery lesions,” as the goal of acute phase treatments for Kawasaki disease. Currently, in addition to immunoglobulin therapy, steroid therapy, therapy using infliximab, biological products, suppression of elastase secretion inside and outside the neutrophils, inactivated ulinastatin therapy and cyclosporine therapy, plasma exchange, etc. are performed. This chapter outlines the history and transition of the acute phase treatment for Kawasaki disease.


Subject(s)
Aneurysm , Arteries , Biological Products , Coronary Vessels , Cyclosporine , Developed Countries , Heart Diseases , Immunization, Passive , Incidence , Inflammation , Infliximab , Mucocutaneous Lymph Node Syndrome , Neutrophils , Pancreatic Elastase , Plasma Exchange , Prednisolone , Vasculitis
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