Diagnosis of Kawasaki disease.
Abstract: Kawasaki disease (KD) is a medium vessel vasculitis with predilection for coronary arteries. Due to lack of a reliable confirmatory laboratory test, the diagnosis of KD is based on a constellation of clinical findings that appear in a typical temporal sequence. These diagnostic criteria have been modified from time to time and the most recent guidelines have been proposed by the American Heart Association (AHA) in 2017. However, several children may have incomplete or atypical forms of KD and the diagnosis can often be difficult, especially in infants and young children. In this review, we have detailed the steps involved in arriving at a diagnosis of KD and also highlight the important role of echocardiography in diagnosis and management of children with KD.
© 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Publication Date: 2017-11-13 PubMed ID: 29131549PubMed Central: PMC7159575DOI: 10.1111/1756-185X.13224Google Scholar: Lookup
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- Journal Article
- Review
Summary
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The research study revolves around the investigation of the causes of Kawasaki disease by conducting serological testing on children suffering from the disease and an examination of potential links to certain viral antibodies and cytotoxins.
Objective of the Research
- The main goal of the study was to explore the etiology, or causes, of Kawasaki disease. This was executed by checking patient serum samples for antibodies associated with four specific viruses and for cytotoxic properties, potentially linked to the cytotoxin produced by a type of bacteria, Propionibacterium acnes.
Research Methodology
- The researchers obtained 13 serum samples from nine children who had been diagnosed with Kawasaki disease.
- They also accumulated 23 control samples for comparative analysis. The control samples are typically taken from individuals who do not have the disease being studied to set a baseline for comparison.
- These samples were screened for the presence of antibodies to four viruses – hog cholera virus, border disease of sheep, bovine diarrhoea virus, and equine arteritis virus.
Results of the Study
- The serum samples, both from children with Kawasaki disease and the control samples, did not exhibit antibodies for the four viruses that were screened.
- They, therefore, concluded that there is no direct relationship between these viruses and the occurrence of Kawasaki disease.
- However, serum samples from two children with Kawasaki disease showed cytotoxic properties. Cytotoxicity refers to a substance’s capacity to be harmful or lethal to certain cells.
Implications of the Study
- The observed cytotoxicity led them to further consider a possible link with a cytotoxin from Propionibacterium acnes – a common type of bacteria that can produce such cytotoxic substances.
- If confirmed, such a link could suggest a bacterial role in the etiology of Kawasaki disease.
- This implies a new avenue of further research to explore this potential link, which may result in an improved understanding of Kawasaki disease and therefore better strategies for its treatment or prevention.
Cite This Article
APA
Singh S, Jindal AK, Pilania RK.
(2017).
Diagnosis of Kawasaki disease.
Int J Rheum Dis, 21(1), 36-44.
https://doi.org/10.1111/1756-185X.13224 Publication
Researcher Affiliations
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
MeSH Terms
- Age of Onset
- Algorithms
- Biomarkers / blood
- Child
- Child, Preschool
- Coronary Vessels / diagnostic imaging
- Coronary Vessels / pathology
- Decision Support Techniques
- Developing Countries
- Echocardiography
- Humans
- Infant
- Mucocutaneous Lymph Node Syndrome / blood
- Mucocutaneous Lymph Node Syndrome / complications
- Mucocutaneous Lymph Node Syndrome / diagnostic imaging
- Mucocutaneous Lymph Node Syndrome / pathology
- Practice Guidelines as Topic
- Predictive Value of Tests
- Prognosis
- Risk Factors
Conflict of Interest Statement
None.
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