LYCOS RETRIEVER 
Kawasaki Disease: Patients
built 627 days ago
Kawasaki disease has many other manifestations that reflect its systemic nature. Urethritis with sterile pyuria is present in 70% of cases. Mild hepatitis with 2-to-4-fold elevations of transaminases occurs in 40% of cases. Diarrhea, nausea or vomiting may be present, usually due to ileus or hepatic inflammation. Hydrops of the gallbladder occurs in <10% of cases and may cause severe right upper quadrant pain; cholecystectomy is not required. Arthritis or arthralgia are present in 10% to 20% of patients and often involve the small joints of the fingers and toes.
Source:
Most Kawasaki patients recover fully from the disease, with no complications later in life. However, approximately 20% will experience cardiac problems caused by the persistence and/or progressive change of weak areas or swellings in the coronary arteries. Also, the coronary artery walls tend to be somewhat thicker and less flexible than normal after the disease, either through calcification (hardening of artery walls) or the early development of atherosclerosis (deposition of fatty materials on the artery walls).
Source:
Myocardial infarction is the principal cause of death in patients with Kawasaki disease. Although infarction may occur during the acute phase of the disease, it more commonly occurs a year or even years later, especially in patients with giant aneurysms. Symptoms of myocardial infarction include inconsolable crying, vomiting, dyspnea, cardiovascular collapse and shock. Most documented cases of infarction have occurred during sleep or at rest.39 In patients with Kawasaki disease, the reported mortality rates for a first myocardial infarction range from 14 to 22 percent.39,40 The mortality rate for a second infarction is 16 percent.40
Source:
During the 2-year study period, 589 children were treated for Kawasaki disease (Figure 1). Of these, 276 were ineligible for the trial; 185 met at least one exclusion criterion, most often being ill for more than 10 days (102 patients), and the remaining 91 did not meet the inclusion criteria. Of the 313 eligible children, 199 (64%) had parental consent for enrollment in the study. Of these, 101 were randomly assigned to receive intravenous methylprednisolone, 30 mg per kilogram, and 98 were randomly assigned to receive placebo. Patients in the two study groups had similar baseline characteristics (Table 1).
Source:
The origins of Kawasaki’s disease remain perplexing. Although a specific infectious agent has not been identified in Kawasaki’s disease, an infectious trigger is suspected. Another perplexing fact is that , unlike other forms of vasculitis, patients with Kawasaki’s disease are not easily treated with corticosteroids.
Source:
In their study, Sectish and his colleagues will compare protein distribution in two groups of patients: children diagnosed with Kawasaki, and children who have had a 100º F fever for at least three days but have been diagnosed with another disease. Blood samples will be taken from both groups and placed in a protein chip array -- a newly designed $350,000 robotic instrument that uses laser technology and mass spectroscopy to identify thousands of proteins at a time.
Source:
MORE ABOUT
Patients