Kawasaki disease: contemporary perspectives

IF 19.9 1区 医学 Q1 PEDIATRICS Lancet Child & Adolescent Health Pub Date : 2024-09-17 DOI:10.1016/S2352-4642(24)00169-X
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引用次数: 0

Abstract

Kawasaki disease is a paediatric vasculitis that presents with fever, rash, conjunctivitis, mucositis, lymphadenopathy, and extremity changes, and primarily affects children younger than 5 years. Coronary artery aneurysms are observed in approximately 20% of patients without treatment. Giant coronary artery aneurysms are rare but can result in substantial morbidity and mortality due to the risk of thrombosis, stenosis, and myocardial infarction. Infants younger than 6 months and children with coronary artery abnormalities are at highest risk for the development of large or giant coronary artery aneurysms, necessitating swift identification and aggressive treatment. The children at high risk for coronary artery aneurysms warrant primary intensification therapy; however, what the most optimal adjunct therapy might be to reduce their risk is unclear and large-scale international trials are needed. Kawasaki disease is a clinical diagnosis that shares many features with other common febrile illnesses, including multisystem inflammatory syndrome in children. Identifying biomarkers that can distinguish Kawasaki disease from similar conditions and predict coronary artery aneurysm risk are needed to aid timely diagnosis, guide management, and improve patient outcomes.

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川崎病:当代视角
川崎病是一种儿科血管炎,表现为发热、皮疹、结膜炎、粘膜炎、淋巴结病和四肢病变,主要影响 5 岁以下的儿童。约有 20% 的患者在未经治疗的情况下会出现冠状动脉瘤。巨大的冠状动脉瘤很少见,但由于存在血栓形成、狭窄和心肌梗死的风险,可导致严重的发病率和死亡率。6 个月以下的婴儿和冠状动脉畸形的儿童发生巨大冠状动脉瘤的风险最高,必须迅速识别并积极治疗。冠状动脉瘤高风险患儿需要进行初级强化治疗;然而,降低其风险的最佳辅助疗法是什么尚不清楚,需要进行大规模的国际试验。川崎病的临床诊断与其他常见发热性疾病(包括儿童多系统炎症综合征)有许多共同之处。我们需要确定能将川崎病与类似疾病区分开来并预测冠状动脉瘤风险的生物标志物,以帮助及时诊断、指导治疗并改善患者预后。
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来源期刊
Lancet Child & Adolescent Health
Lancet Child & Adolescent Health Psychology-Developmental and Educational Psychology
CiteScore
40.90
自引率
0.80%
发文量
381
期刊介绍: The Lancet Child & Adolescent Health, an independent journal with a global perspective and strong clinical focus, presents influential original research, authoritative reviews, and insightful opinion pieces to promote the health of children from fetal development through young adulthood. This journal invite submissions that will directly impact clinical practice or child health across the disciplines of general paediatrics, adolescent medicine, or child development, and across all paediatric subspecialties including (but not limited to) allergy and immunology, cardiology, critical care, endocrinology, fetal and neonatal medicine, gastroenterology, haematology, hepatology and nutrition, infectious diseases, neurology, oncology, psychiatry, respiratory medicine, and surgery. Content includes articles, reviews, viewpoints, clinical pictures, comments, and correspondence, along with series and commissions aimed at driving positive change in clinical practice and health policy in child and adolescent health.
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