French national diagnostic and care protocol for Kawasaki disease.
Details
Serval ID
serval:BIB_D53F8A66E5F4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
French national diagnostic and care protocol for Kawasaki disease.
Journal
La Revue de medecine interne
Working group(s)
collaborators
ISSN
1768-3122 (Electronic)
ISSN-L
0248-8663
Publication state
Published
Issued date
07/2023
Peer-reviewed
Oui
Volume
44
Number
7
Pages
354-380
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
Kawasaki disease (KD) is an acute vasculitis with a particular tropism for the coronary arteries. KD mainly affects male children between 6 months and 5 years of age. The diagnosis is clinical, based on the international American Heart Association criteria. It should be systematically considered in children with a fever, either of 5 days or more, or of 3 days if all other criteria are present. It is important to note that most children present with marked irritability and may have digestive signs. Although the biological inflammatory response is not specific, it is of great value for the diagnosis. Because of the difficulty of recognising incomplete or atypical forms of KD, and the need for urgent treatment, the child should be referred to a paediatric hospital as soon as the diagnosis is suspected. In the event of signs of heart failure (pallor, tachycardia, polypnea, sweating, hepatomegaly, unstable blood pressure), medical transfer to an intensive care unit (ICU) is essential. The standard treatment is an infusion of IVIG combined with aspirin (before 10 days of fever, and for a minimum of 6 weeks), which reduces the risk of coronary aneurysms. In case of coronary involvement, antiplatelet therapy can be maintained for life. In case of a giant aneurysm, anticoagulant treatment is added to the antiplatelet agent. The prognosis of KD is generally good and most children recover without sequelae. The prognosis in children with initial coronary involvement depends on the progression of the cardiac anomalies, which are monitored during careful specialised cardiological follow-up.
Keywords
Child, Humans, Male, Infant, Mucocutaneous Lymph Node Syndrome/diagnosis, Mucocutaneous Lymph Node Syndrome/therapy, Mucocutaneous Lymph Node Syndrome/complications, Aspirin/therapeutic use, Fever/etiology, Vasculitis/complications, Coronary Aneurysm/diagnosis, Coronary Aneurysm/etiology, Coronary Aneurysm/therapy, Immunoglobulins, Intravenous/therapeutic use, Diagnosis, Diagnostic, Follow-up, Kawasaki disease, Maladie de Kawasaki, Suivi, Traitement, Treatment
Pubmed
Web of science
Create date
11/12/2024 10:13
Last modification date
12/12/2024 10:51