Materiały źródłowe

• #1 Kawasaki Disease: Summary of the American Heart Association Guidelines | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1001/p1141.html

  Kawasaki disease is the leading cause of acquired heart disease among children in developed countries. […] First-line treatment for Kawasaki disease is IVIG in a dose of 2 g per kg of body weight in a single infusion. […] For treatment of Kawasaki disease, high-dose aspirin (80 to 100 mg per kg per day, divided into four doses) should be given with IVIG. […] Without treatment, coronary artery abnormalities develop in about 15 to 25 percent of patients with Kawasaki disease. Fortunately, with prompt therapy this percentage decreases to about 5 percent for any abnormality (including transient abnormalities) and 1 percent for giant coronary artery aneurysms. […] Therapy should be initiated within 10 days of fever onset if possible; however, children who present after 10 days of fever still should be treated if fever or other signs of persistent inflammation are present, including an elevated ESR or CRP level.

• #1 Kawasaki Disease: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13457-kawasaki-disease

  No. Because researchers dont know what causes Kawasaki disease, they dont know how to prevent it.

• #2

  https://www.nhs.uk/conditions/kawasaki-disease/

  Kawasaki disease can’t be prevented. […] It’s best if treatment begins as soon as possible. The sooner treatment starts, the quicker the recovery time and there’s less risk of complications developing.

• #3 Kawasaki Disease: Symptoms, Treatment and Prevention – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/kawasaki-disease

  Kawasaki disease can not be prevented as the cause is unknown. […] Early diagnosis and treatment can however reduce the likelihood of long-term impacts on the heart.

• #4 Kawasaki Disease – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/kawasaki-disease.page

  At this time, there are no proven preventive measures for Kawasaki disease.

• #5 Kawasaki Syndrome | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/kawasaki-syndrome/

  There are no known measures that will prevent this illness.

• #6 Kawasaki Syndrome | South Dakota Department of Health

  https://doh.sd.gov/diseases/kawasaki-syndrome/

  At the present time, preventive measures are unknown.

• #7 Kawasaki Disease | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/kawasaki-disease

  At this time there are no means of prevention, nor is there evidence that the disease is contagious. […] If diagnosed with Kawasaki disease, your child will be given a high dose of gamma globulin (purified antibodies) intravenously, which helps prevent damage to the coronary artery. […] Early detection and treatment greatly reduce the risk of future complications.

• #8 Kawasaki Disease | Tampa Rheumatology

  https://www.tamparheumatology.com/kawasaki-disease.php

  Kawasaki disease is not contagious and cannot be prevented. […] It is important to treat Kawasaki disease as promptly as possible. When treatment is begun within 10 days of onset, the possibility of residual complications is greatly reduced. […] Treatments used to prevent complications include infusions of gamma globulin to lower risk of coronary artery problems and administration of high doses of aspirin to treat inflammation. […] Even after the child has no fever, low-dose aspirin may be administered for at least 6 weeks to prevent blood clotting.

• #9 Pandemic prevention measures linked to lower rates of Kawasaki disease in children | American Heart Association

  https://newsroom.heart.org/news/pandemic-prevention-measures-linked-to-lower-rates-of-kawasaki-disease-in-children

  Rates of Kawasaki disease a condition that creates inflammation in blood vessels in the heart and is more common in children of Asian/Pacific Island descent have substantially decreased in South Korea during the COVID-19 pandemic. […] The decrease could be due to mask-wearing, hand-washing, school closures and physical distancing, suggesting Kawasaki disease may be prompted by infectious agents. […] South Korean researchers noted that efforts to prevent COVID-19 provided a unique opportunity to analyze the possible effects of mask-wearing and social distancing on Kawasaki disease. […] The broad and intensive COVID-19 prevention interventions had the additional effect of lowering the incidence of respiratory infections, which have previously been suggested as triggering agents for Kawasaki disease, Ahn noted.

• #10 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20210607/Kawasaki-disease-in-children-has-reduced-during-COVID-19-due-to-pandemic-prevention-efforts.aspx

  The rate of Kawasaki disease in South Korea has substantially decreased during the COVID-19 pandemic, possibly due to pandemic prevention efforts, such as mask-wearing, hand-washing and physical distancing, according to new research published today in the American Heart Association’s flagship journal Circulation. […] Researchers compared the rate of Kawasaki disease from February 2020 to September 2020, a time of significant COVID-19 prevention efforts, to pre-COVID-19 rates of Kawasaki disease. Their analysis found the number of Kawasaki disease cases dropped substantially — by about 40% — after COVID-19 prevention efforts were implemented in Feb. 2020. […] The broad and intensive COVID-19 prevention interventions had the additional effect of lowering the incidence of respiratory infections, which have previously been suggested as triggering agents for Kawasaki disease.

• #11 Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence

  https://www.jstage.jst.go.jp/article/jea/31/11/31_JE20210132/_article

  Kawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease. […] These observations provide a new epidemiological evidence for the notion that Kawasaki disease is triggered by major infectious diseases in children.

• #12 Kawasaki disease declines during pandemic, offering clues for prevention – UPI.com

  https://www.upi.com/Health_News/2022/06/21/Kawasaki-disease-declines-during-pandemic-offering-clues-for-prevention/2881655819659/

  A decline in cases of a rare heart disease in children during the COVID-19 pandemic may provide clues about its cause and how to prevent it, researchers say. […] The drop in KD cases corresponded with school closures, mask mandates, lower air pollution levels and reduced spread of respiratory viruses. […] If confirmed, the finding could have a significant impact on KD research and prevention, they added.

• #13 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20210607/Kawasaki-disease-in-children-has-reduced-during-COVID-19-due-to-pandemic-prevention-efforts.aspx

  During the COVID pandemic, children were exposed to fewer viruses and other infectious agents. So the 'natural experiment’ that occurred from isolation and masking of children supports the likelihood that Kawasaki disease is triggered by viruses or other infectious agents in the environment. […] The decrease in the incidence of Kawasaki disease after the implementation of non-pharmaceutical interventions is very clear, and it is unlikely that other independent interventions were accidentally involved.

• #14 Kawasaki disease – Wikipedia

  https://en.wikipedia.org/wiki/Kawasaki_disease

  Typically, initial treatment of Kawasaki disease consists of high doses of aspirin and immunoglobulin. […] Without treatment, coronary artery aneurysms occur in up to 25% and about 1% die. […] With treatment, the risk of death is reduced to 0.17%. […] People who have had coronary artery aneurysms after Kawasaki disease require lifelong cardiological monitoring by specialized teams. […] Children with Kawasaki disease should be hospitalized and cared for by a physician who has experience with this disease. […] To prevent damage to coronary arteries, treatment should be started immediately following the diagnosis. […] Intravenous immunoglobulin (IVIG) is the standard treatment for Kawasaki disease and is administered in high doses with marked improvement usually noted within 24 hours.

• #15 Kawasaki Disease: Symptoms, Diagnosis and Treatment

  https://www.nationwidechildrens.org/conditions/kawasaki-disease

  When treatment begins within 10 days of the start of the disease, there is little risk of blood vessel and heart problems. […] There is no way to prevent Kawasaki Disease. […] Aspirin helps control fever and inflammation and it keeps blood cells from clumping or forming clots. […] Your child will need to take aspirin for at least 6 weeks after going home. Usually children should not be given aspirin, but in this case, it is needed and helpful. […] Hold off getting vaccines that use live viruses like the MMR and Varicella (chickenpox) for 11 months after having IVIG treatment.

• #16 Kawasaki Disease: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/965367-overview

  Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome and Kawasaki syndrome, is an acute febrile illness of early childhood characterized by vasculitis of the medium-sized arteries. Given its predilection for the coronary arteries, there is a potential for the development of coronary artery aneurysms (CAAs) and thus sudden death. CAAs develop in approximately 25% of untreated cases; appropriate treatment decreases this risk to 3-5%. […] The principal goal of treatment is to prevent coronary artery disease. Intravenous immunoglobulin (IVIG), a purified preparation of gamma globulin, and aspirin are the mainstays of treatment. Patients should be treated with IVIG within 10 days after the onset of fever to prevent the development of cardiac sequelae. […] Therapy with IVIG should be started within 10 days, and ideally within 7 days, of fever onset to prevent cardiac complications. […] The patient will need to follow up with a primary care doctor and a cardiologist after discharge from the hospital. This is very important so that the patient is appropriately treated and monitored for heart complications.

• #17 Kawasaki Disease | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kawasaki

  Kawasaki disease is an illness that makes the blood vessels in the body swell and become inflamed. […] Without medical evaluation and treatment, however, serious complications may develop and not be initially recognized. […] With appropriate and timely treatment, the risk of coronary artery involvement decreases to around 5%. […] The infusion is most effective if given within the first 10 days of the illness, decreasing the risk of developing coronary changes from 25% to less than 5%. […] Your child will continue to be followed by a cardiologist after Kawasaki disease resolves. […] It is prudent for families and patients to practice heart healthy habits that help to prevent adult coronary artery disease and heart attacks.

• #18 What Is Kawasaki Disease? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/kawasaki-disease/guide/

  With early detection and treatment, long-term heart issues are unlikely to occur. […] The main reason we treat Kawasaki disease is to try to prevent these possible cardiac outcomes, says Vijaya Soma, MD, a clinical assistant professor in the department of pediatrics at New York Universitys Grossman School of Medicine, who specializes in pediatric infectious disease. […] Treatment administered within the first 10 days of symptoms significantly reduces the risk of coronary artery damage and also helps resolve other symptoms. […] Without treatment, up to 25 percent of children develop heart problems such as coronary artery aneurysms, which typically begin one to four weeks after the onset of Kawasaki disease. Treatment lowers the risk of heart complications to about 1 in 20. […] If a child develops aneurysms, they have an increased risk of having heart problems as adults, even if the aneurysms resolve.

• #19 Prognosis and prevention for Kawasaki disease

  https://www.mymed.com/diseases-conditions/kawasaki-disease/prognosis-and-prevention-for-kawasaki-disease

  Generally, Kawasaki disease will resolve through early treatment within four to eight weeks, after which, you can expect a full recovery. […] As with most illnesses, when your child is diagnosed early, the risk of complications arising is significantly decreased. It is vital that you recognise the signs and symptoms of Kawasaki disease and make an appointment to see your doctor if you feel your child may be ill. […] Due to the fact that the exact cause of the condition is yet to be identified, there are currently no measures in place that have been known to prevent the occurrence of the disease. This makes the early detection of the disease vital in preventing further complications.

• #20 Breakthrough Toward Finding Cause of Kawasaki Disease in Children | Lurie Children’s

  https://www.luriechildrens.org/en/news-stories/breakthrough-toward-finding-cause-of-kawasaki-disease-in-children/

  Establishing the exact cause, which is believed to be viral, is critical to advancing the diagnosis, treatment and prevention of Kawasaki disease. […] The standard treatment, intravenous immunoglobulin and aspirin, substantially decreases the risk of heart disease in Kawasaki disease patients. […] Once we establish the cause of Kawasaki disease, we can work on developing a vaccine to prevent these infections in children, says Dr. Rowley. […] We have the responsibility to keep searching, to deliver those answers and optimize diagnosis, treatment and prevention of Kawasaki disease.

• #21 Kawasaki Disease: Mysterious Childhood Illness | Maggie Yu MD, IFMCP

  https://drmaggieyu.com/blog/kawasaki-disease-mysterious-childhood-illness/

  Kawasaki disease, this mysterious childhood illness, has no specific prevention measures due to its unknown cause. However, theres a standard treatment protocol that includes immunoglobulin therapy and aspirin management. […] The tricky thing about Kawasaki disease is that we dont know what causes it. Its like trying to dodge raindrops in a storm without knowing where theyll land next. This makes it challenging to develop specific preventive measures. […] When your kiddo gets diagnosed with Kawasaki disease, the go-to treatment is something called intravenous immunoglobulin (IVIG) therapy. Think of IVIG as a superhero swooping in to save the day! Its a blood product administered through veins that helps reduce inflammation and protect against heart damage. […] Apart from IVIG therapy, doctors often use an old-school remedy aspirin. Yeah, Im talking about that over-the-counter pill you take for headaches or fevers! In this case, aspirin helps manage inflammation and reduces fever associated with Kawasaki disease.

• #22 Kawasaki Disease Program | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/kawasaki-disease-program

  Kawasaki disease is a condition that causes inflammation in a childs body and blood vessels in multiple organs, including the coronary artery in the heart. […] If your child is experiencing high fever, swollen limbs, peeling skin, red eyes and swollen reddish tongue, we recommend that your child receives treatment as soon as possible to avoid the development of coronary artery aneurysms. […] Aspirin helps treat your childs inflammation and prevents clots from forming in the coronary artery. Aspirin can also decrease pain, joint inflammation and fever. […] Intravenous immune globulin (IVIG). We will infuse the immune protein (gamma globulin) through your childs vein which can lower the risk of developing coronary artery problems. This helps to reduce inflammation in your child. […] Once your child is discharged from the hospital, we strongly suggest that your child visit a cardiologist one to two weeks after discharge and then six weeks after discharge. […] If your child has developed a coronary artery aneurysm, we will treat your child with: Infliximab. This monoclonal antibody works to enhance your child’s immune system. […] It’s important to keep follow-up visits with your child’s healthcare provider, even if your child is feeling well.

• #23 Kawasaki disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603

  It’s best to start treatment for Kawasaki disease as early as possible, when your child still has a fever. Treatment for Kawasaki disease often happens in a hospital. The goals of treatment are to lower fever, reduce swelling and prevent heart damage. […] Gamma globulin is given through a vein. This treatment lowers inflammation in the blood vessels. It can lower the risk of problems with the heart artery. […] After getting gamma globulin, wait at least 11 months to get a live vaccine, such as the chickenpox or measles vaccine. Gamma globulin can affect how well these vaccines work. […] High doses of aspirin might help treat inflammation. Aspirin also can decrease pain, joint swelling and fever. […] A healthcare professional needs to oversee giving aspirin to children with Kawasaki disease.

• #24 Kawasaki Disease Treatment & Management: Approach Considerations, Intravenous Immunoglobulin, Treatment of IVIG-Resistant Disease

  https://emedicine.medscape.com/article/965367-treatment

  The principal goal of treatment for KD is to prevent coronary artery aneurysms and other cardiac complications. The mainstays of treatment for KD are IVIG and aspirin. All patients with KD should be admitted to the hospital for administration of IVIG, echocardiography, initiation of aspirin, and for observation until fevers have resolved. […] It is important to note that the American Academy of Pediatrics Red Book states that live vaccinations are contraindicated for 11 months after administration of IVIG for KD. […] Guidelines from the AHA recommend a second dose of IVIG, methylprednisolone, a longer tapering course of prednisolone or prednisone plus IVIG, or infliximab be considered for patients resistant to IVIG. […] Guidelines from the ACR and the Vasculitis Foundation conditionally recommend the use of adjunctive glucocorticoids with IVIG as initial therapy for patients with acute KD who are at high risk for IVIG resistance or the development of coronary artery aneurysms.

• #25 What Is Kawasaki Disease? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/kawasaki-disease/guide/

  Even though the risk is low, it is important that the child be followed closely in the first six weeks after the diagnosis [of Kawasaki disease] is made to see if the coronary arteries show signs of being affected. […] The AAP recommends that live viral vaccines be postponed for 11 months after a child is treated for Kawasaki disease, because the treatment may reduce the effectiveness of vaccines for illnesses including MMR (measles, mumps, rubella) and varicella (chicken pox).

• #26 Aspirin Dose and Prevention of Coronary Abnormalities in Kawasaki Disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28562282/

  Acetylsalicylic acid (ASA) is part of the recommended treatment of Kawasaki disease (KD). […] In conjunction with intravenous immunoglobulin, low-dose ASA in acute KD is not inferior to high-dose ASA for reducing the risk of CA abnormalities.

• #27 Kawasaki Disease or Incomplete Kawasaki Disease — Antiplatelet Therapy — Clinical Pathway: Emergency, Inpatient | Children’s Hospital of Philadelphia

  https://www.chop.edu/clinical-pathway/kawasaki-disease-incomplete-kawasaki-disease-aspirin

  Aspirin has been used in the treatment of KD for its anti-inflammatory activity at high doses (early in the disease) and anti-platelet activity at low doses (for chronic thromboprophylaxis). […] There is no evidence that aspirin decreases the incidence of coronary artery abnormalities, and there is no data to suggest that a high vs. moderate dose of aspirin is superior. […] The AHA guidelines state it is reasonable to administer moderate- or high-dose aspirin until the patient is afebrile, although there is no evidence it reduces coronary artery aneurysms. […] This pathway does not recommend high-dose aspirin in those already receiving steroids, since steroids offer a powerful anti-inflammatory effect. […] This pathway suggests transitioning to low-dose ASA after 24 hours to allow for a better assessment of fever and treatment resistance prior to discharge.

• #28 Kawasaki Disease: Summary of the American Heart Association Guidelines | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1001/p1141.html

  High-dose aspirin is administered initially for its anti-inflammatory effect. […] Low-dose aspirin (3 to 5 mg per kg per day, given as a single dose) has an antiplatelet effect and should be continued until six to eight weeks after disease onset if there are no coronary artery abnormalities or indefinitely if abnormalities are present. […] In general, ibuprofen should be avoided in children taking aspirin because it may antagonize the antiplatelet effect of aspirin. […] About 85 to 90 percent of patients respond promptly to initial therapy of IVIG and high-dose aspirin; however, others have persistent or recurrent fever beyond 36 hours of therapy and require further treatment. […] In most centers, patients who fail to respond to the first dose of IVIG are given a second dose of 2 g per kg.

• #29

  https://link.springer.com/article/10.1007/s11908-021-00746-1

  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). […] 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. […] The 2017 American Heart Association (AHA) treatment guidelines have included changes in aspirin dosing (including both 80100 mg/kg/day and 3050 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.

• #30 Effect of different doses of aspirin on the prognosis of Kawasaki disease | Pediatric Rheumatology | Full Text

  https://ped-rheum.biomedcentral.com/articles/10.1186/s12969-020-00432-x

  Aspirin is used with intravenous immunoglobulin (IVIG) to prevent coronary artery abnormalities in KD. […] The initial treatment of KD with IVIG has generally reached consensus worldwide. However, there is still controversy about the appropriate aspirin dose to be used as a secondary cornerstone treatment. […] In conclusion, our data show that in clinical practice, the commonly recommended dosage of 3050mg/kg/day of aspirin is not better than 2029mg/kg/day.

• #31 Kawasaki disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603

  Once the fever goes down, a child might need to take low-dose aspirin for at least six weeks. This can be longer if there are problems with the heart artery. Aspirin helps prevent blood clotting. […] If your child has any signs of heart problems, the healthcare professional might suggest follow-up tests to check your child’s heart health. Tests are often done 6 to 8 weeks after the illness began, and then again after six months.

• #32 Kawasaki Disease or Incomplete Kawasaki Disease — Antiplatelet Therapy — Clinical Pathway: Emergency, Inpatient | Children’s Hospital of Philadelphia

  https://www.chop.edu/clinical-pathway/kawasaki-disease-incomplete-kawasaki-disease-aspirin

  For patients with increased risk of thrombosis (large or giant aneurysms and recent history of coronary artery thrombosis), triple therapy with antiplatelet medications, 2nd antiplatelet agent and anticoagulation may be considered. […] Ibuprofen and other NSAIDs may be harmful in patients taking ASA for its antiplatelet effects and should be avoided. […] Avoid ibuprofen or other NSAID (antagonizes anti-platelet effect of aspirin and clopidogrel). […] There is no evidence that ASA decreases aneurysms or that outcomes are different with low- vs. high-dose ASA. […] Low-dose ASA is necessary for thrombosis prevention and should be continued through discharge, with length of therapy.

• #33

  https://link.springer.com/article/10.1007/s11908-021-00746-1

  This study showed benefit of adjunctive corticosteroids in patients predicted to have IVIG resistance in the initial treatment of KD. The current AHA recommendation for consideration of adjunct corticosteroid therapy in patients at high risk for IVIG resistance resembles this study’s regimen based on strength of this study’s design and findings.

• #34 A Clinical Trial for Kawasaki Disease – KD-CAAP – Societi

  https://www.societi.org.uk/kd-caap/

  KD-CAAP stands for: Kawasaki Disease Coronary Artery Aneurysm Prevention. […] The KD-CAAP trial is doing just that investigating a possible way to prevent these coronary artery aneurysms. […] The results of the trial will help doctors to know if adding a steroid to standard treatment will lower the number of children with Kawasaki Disease who will get serious, lifelong heart damage.

• #35 Clinical Trial Opens for Childhood Kawasaki Disease

  https://metab.ern-net.eu/kawasaki-disease-coronary-artery-aneurysm-prevention-trial/

  The first site is open to recruitment into one of the three inaugural studies which will be utilising the infrastructure and resources of the conect4children network. […] To prevent heart damage, Kawasaki disease in children and young people must be recognised by clinicians early, and promptly treated with anti-inflammatory medicines. […] The study will assess the effectiveness of adding steroids to standard treatment in children with Kawasaki Disease and aims to recruit 262 children as part of the study.

• #36 Kawasaki disease – Wikipedia

  https://en.wikipedia.org/wiki/Kawasaki_disease

  IVIG given within the first 10 days of the disease reduces the risk of damage to the coronary arteries in children, without serious adverse effects. […] Aspirin therapy is started at high doses until the fever subsides, and then is continued at a low dose when the patient returns home, usually for two months to prevent blood clots from forming. […] Due to the potential involvement of the upregulated calcium-nuclear factor of activated T cells pathway in the development of the disease, a 2019 study found that the combination of ciclosporin and IVIG infusion can suppress coronary artery abnormalities. […] Evidence indicates Kawasaki disease produces altered lipid metabolism that persists beyond the clinical resolution of the disease.

• #37 Immunoglobulin plus Cyclosporine for Prevention of Coronary Artery Abnormalities in Kawasaki Diseaselogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na48739/2019/04/03/immunoglobulin-plus-cyclosporine-prevention-coronary

  Although combined therapy led to lower incidence of coronary artery abnormalities, important caveats may limit the findings’ relevance. […] Cyclosporine targets genetic variants related to Kawasaki disease and its consequences, making it a candidate for therapy, particularly in children at higher risk for not responding to intravenous immunoglobulin (IVIG) alone. […] Overall incidence of coronary artery abnormality was lower in the intervention group (14% vs. 31%; risk ratio, 0.46; 95% confidence interval, 0.25–0.86), but prevalence at 12 weeks was not statistically different. […] Given the still uncertain balance between risks and benefits, clinicians considering this approach should be aware of the important caveats.

• #38 Kawasaki Disease: Summary of the American Heart Association Guidelines | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1001/p1141.html

  Serial echocardiography, performed at a center experienced in examining the coronary arteries of children, is indicated for those with acute Kawasaki disease. […] The acute management of patients with coronary artery abnormalities depends on the extent and severity of the lesion, and decisions usually are made in consultation with a pediatric cardiologist. […] Long-term antiplatelet therapy is indicated for these patients, and warfarin or low-molecular-weight heparin should be added for patients with giant aneurysms.

• #39 Kawasaki disease: guidelines of Italian Society of Pediatrics, part II – treatment of resistant forms and cardiovascular complications, follow-up, lifestyle and prevention of cardiovascular risks | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-018-0529-2

  This second part of practical Guidelines related to Kawasaki disease (KD) has the goal of contributing to prompt diagnosis and most appropriate treatment of KD resistant forms and cardiovascular complications, including non-pharmacologic treatments, follow-up, lifestyle and prevention of cardiovascular risks in the long-term through a set of 17 recommendations. […] Scope of these revised Guidelines is to update evidence on the following topics: […] lifestyle and prevention of cardiovascular risks. […] The clinical management of each KD patient requires the application of these recommendations based on the peculiar patient’s condition. […] It is reasonable to consider KD patients worthy of close monitoring for cardiovascular risks, evaluating blood pressure, body mass index, cholesterol, LDL, HDL, triglycerides, and promoting correct lifestyles (for instance, avoid smoking) and a regular physical activity with healthy eating.

• #40 Kawasaki disease: guidelines of Italian Society of Pediatrics, part II – treatment of resistant forms and cardiovascular complications, follow-up, lifestyle and prevention of cardiovascular risks | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-018-0529-2

  Monitoring cardiovascular risk factors in KD patient requires body mass index evaluation, blood pressure control, and evaluation of the lipid profile (total cholesterol, LDL, HDL, triglycerides). […] Physical activity is recommended according to the following indications: […] risk level I e II: no restriction of physical activity (non-agonistic) if clinical assessment and instrumental tests are normal after 6–8 weeks. […] risk level III: no restriction of physical activity (non-agonistic) for children younger than 10–11 years after 6–8 weeks, then based on stress test each time a new certification is required. […] risk level IV: physical activity is established on annual stress test and evaluation of myocardial perfusion. […] risk level V: physical activity is established via six-monthly stress test with at least annual evaluation of the myocardial perfusion.

• #41 What Is Kawasaki Disease? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/kawasaki-disease/guide/

  But if your child doesnt develop a coronary aneurysm, they are likely to have an excellent long-term outcome, according to the AAP, which says that after treatment, children will benefit from a heart-healthy diet and lifestyle, and monitoring of cholesterol levels. […] The standard treatment for Kawasaki disease consists of high doses of both aspirin and immunoglobulin, which is a purified form of proteins and antibodies from donated blood. […] These treatments can substantially reduce the risk of serious heart complications and should be started as soon as possible. […] Children with large coronary aneurysms may be given anticoagulants, which are drugs that prevent the blood from clotting. […] The risk of developing coronary disease in children treated with immunoglobulin therapy is low, says Daphne T. Hsu, MD, the division chief of pediatric cardiology and the co-director of the pediatric heart center at Childrens Hospital at Montefiore in New York City.

• #42 Kawasaki Disease Treatment & Management: Approach Considerations, Intravenous Immunoglobulin, Treatment of IVIG-Resistant Disease

  https://emedicine.medscape.com/article/965367-treatment

  Patients who remain on long-term, low-dose aspirin should receive an annual influenza vaccine and be vaccinated against varicella. Additionally, the risks of developing Reye syndrome during an active infection with influenza or varicella should be addressed. […] Long-term management begins at the end of the acute illness, typically 5-6 weeks after fever onset. This is typically when coronary artery involvement has reached its maximal extent and luminal dimensions. Thromboprophylaxis and careful echocardiographic surveillance for coronary artery stenoses and obstructions, as well as myocardial ischemia, are the pillars of management.

• #43 Kawasaki Disease – What You Need to Know

  https://www.drugs.com/cg/kawasaki-disease.html

  What can I do to prevent the spread of germs? […] Ask about vaccines your child needs. Vaccines help prevent some infections that cause disease. Have your child get a yearly flu vaccine as soon as recommended, usually in September or October. Your child’s healthcare provider can tell you other vaccines your child should get, and when to get them.

• #44 Kawasaki Disease – Causes, Symptoms, Treatment, Diagnosis – MedBroadcast.com

  https://medbroadcast.com/condition/getcondition/kawasaki-disease

  If Kawasaki disease is treated early, there’s less of a chance of coronary artery damage. […] Children with the condition get high doses of intravenous immunoglobulin as soon as the diagnosis is made. They’re also given very high doses of acetylsalicylic acid* (ASA). After their fever has gone down, children with Kawasaki disease are given a lower dose of ASA for a few months. This treatment prevents the blood from clotting in case there is some damage to the coronary arteries. […] Live-virus vaccines, such as vaccines for measles, mumps, rubella and chickenpox, should be delayed by about 1 year for children given immunoglobulin since the vaccines may not work as well.

• #45 Finding a Cause for Kawasaki Disease

  https://www.childrenshospitals.org/news/childrens-hospitals-today/2020/04/finding-a-cause-for-kawasaki-disease

  „Establishing the exact cause, which is believed to be viral, is critical to advancing the diagnosis, treatment and prevention of Kawasaki disease,” Rowley says. […] „Once we establish the cause, we can work on developing a vaccine to prevent these infections,” Rowley says. […] „We have the responsibility to keep searching, to deliver those answers and optimize diagnosis, treatment and prevention of Kawasaki disease.”

• #46 Kawasaki Disease: A Heart Disorder Affecting Children

  https://www.samitivejhospitals.com/article/detail/Kawasaki-Disease-heart-disorder

  Prevention of Kawasaki disease is currently unavoidable, however the treatment can be successful if carried out within 10 days of the symptoms first being displayed, as this reduces the risk of complications that could arise in the coronary artery. […] Although there is no prevention for Kawasaki disease, successful treatment is possible when carried out within 10 days of the symptoms first being displayed. Early treatment reduces complications that could arise in the coronary artery.

• #47 Kawasaki Disease: Signs and Symptoms, Types, Causes, Risk Factors, Tests and Treatment, Prevention Tips and Faqs

  https://www.healthandme.com/health/kawasaki-disease

  Kawasaki disease cannot be prevented as its exact causes are unknown. However, early diagnosis and treatment can reduce the risk of developing heart complications. […] One must ensure that the affected child’s vaccinations are up to date, such as influenza, COVID-19, measles-mumps-rubella and varicella, while taking a daily dosage of aspirin.

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