scholarly journals Cardiovascular Lesions of Kawasaki Disease: From Genetic Study to Clinical Management

Author(s):  
Ho-Chang Kuo ◽  
Wei-Chiao Chang
2021 ◽  
Vol 23 (3) ◽  
Author(s):  
Frank Zhu ◽  
Jocelyn Y. Ang

Abstract Purpose of Review Provide an updated review of the clinical management and diagnosis of Kawasaki disease with inclusion of potential diagnostic difficulties with multisystem inflammatory syndrome in children (MIS-C) given the ongoing COVID-19 pandemic. Recent Findings Adjunctive corticosteroid therapy has been shown to reduce the rate of coronary artery dilation in children at high risk for IVIG resistance in multiple Japanese clinical studies (most notably RAISE study group). Additional adjunctive therapies (etanercept, infliximab, cyclosporin) may also provide limited benefit, but data is limited to single studies and subgroups of patients with cardiac abnormalities. The efficacy of other agents (atorvastatin, doxycycline) is currently being investigated. MIS-C is a clinically distinct entity from KD with broad clinical manifestations and multiorgan involvement (cardiac, GI, hematologic, dermatologic, respiratory, renal). MIS-C with Kawasaki manifestations is more commonly seen in children < 5 years of age. Summary The 2017 American Heart Association (AHA) treatment guidelines have included changes in aspirin dosing (including both 80–100 mg/kg/day and 30–50 mg/kg/day treatment options), consideration of the use of adjuvant corticosteroid therapy in patients at high risk of IVIG resistance, and the change in steroid regimen for refractory KD to include both pulse-dose IVMP and longer course of prednisolone with an oral taper. A significant proportion of children diagnosed with MIS-C, a post-infectious syndrome of SARS-CoV-2 infection, meet criteria for Kawasaki disease. Further investigation is warranted to further delineate these conditions and optimize treatment of these conditions given the ongoing COVID-19 pandemic.


2020 ◽  
Vol 8 ◽  
Author(s):  
Yoshihiro Azuma ◽  
Yasuo Suzuki ◽  
Seigo Okada ◽  
Chie Matsuguma ◽  
Hiroyuki Wakiguchi ◽  
...  

2003 ◽  
Vol 53 (1) ◽  
pp. 165-165
Author(s):  
Iman Kahwaji ◽  
David Connuck ◽  
Nebiat Tafari ◽  
Nagib Dahdah

1992 ◽  
Vol 23 (1) ◽  
pp. 6-8 ◽  
Author(s):  
Carol W. Lawrence

Speech-language evaluation reports from many institutions present age-equivalent scores as the evidence for speech-language deficits. Yet, the value and interpretation of this measurement criterion requires clinical scrutiny. This article reviews the concept and derivation of age-equivalent scores and presents arguments against their use in case management decisions.


1988 ◽  
Vol 19 (1) ◽  
pp. 5-16 ◽  
Author(s):  
Karen E. Pollock ◽  
Richard G. Schwartz

The relationship between syllabic structure and segmental development was examined longitudinally in a child with a severe phonological disorder. Six speech samples were collected over a 4-year period (3:5 to 7:3). Analyses revealed gradual increases in the complexity and diversity of the syllable structures produced, and positional preferences for sounds within these forms. With a strong preference for [d] and [n] at the beginning of syllables, other consonants appeared first at the end of syllables. Implications for clinical management of phonological disorders include the need to consider both structural position and structural complexity in assessing segmental skills and in choosing target words for intervention.


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