Document Detail


Kawasaki disease.
MedLine Citation:
PMID:  17484817     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Kawasaki disease is an acute vasculitis of childhood, complicated by coronary artery aneurysms in up to 25% of affected children. High-dose intravenous immunoglobulin (IVIG) administered in the acute phase of Kawasaki disease leads to a fivefold reduction in the prevalence of coronary aneurysms. When fever persists, a second IVIG infusion should be administered. Rescue therapies for IVIG-resistant Kawasaki disease include pulsed-dose methylprednisolone or other steroid regimens, as well as infliximab, a tumor necrosis factor-alpha antagonist. Aspirin is used initially in an anti-inflammatory dosage, then at a low dosage until approximately 6 weeks after illness onset. Patients with coronary aneurysms require chronic antithrombotic therapy. For small aneurysms, aspirin alone is sufficient. For larger aneurysms, agents added to aspirin include clopidogrel and, for giant aneurysms, warfarin or low molecular weight heparin. Long-term management is tailored to the degree of coronary artery involvement. Evidence-based data to guide indications for transcatheter and surgical intervention are limited.
Authors:
Jane W Newburger; David R Fulton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  9     ISSN:  1092-8464     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-05-08     Completed Date:  2010-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  148-58     Citation Subset:  -    
Affiliation:
Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. jane.newburger@cardio.chboston.org
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