@article{PM4767,
author = {Robert Grignani and Swee-Chye Quek},
title = {Kawasaki disease in 2019—past controversies, present insights and future directions: a narrative review},
journal = {Pediatric Medicine},
volume = {2},
number = {0},
year = {2019},
keywords = {},
abstract = {Background and Objective: Kawasaki disease (KD) is a condition that is of interest to many pediatricians. Notwithstanding possible complications to coronary arteries, there is much that is yet unknown, including the controversies which surround this vasculitis. This article discusses evolution of our knowledge in KD over 5 decades, and reviews the advances which have been made.
Methods: We searched relevant articles in PubMed and also using Google Scholar search engine on 1 October 2018 without any date restrictions. The main search term included Kawasaki disease combined with paediatric using AND operator, and further combining these terms with phrases like diagnosis, management, echocardiography, risk factors, IVIG resistance, treatment, post-KD vascular health. Being a narrative review, we did not have any specific exclusion criteria and included all types of study designs published in English language, as long as they provided information to meet the scope of the current narrative review.
Key Content and Findings: Making a timely and accurate diagnosis is essential for appropriate treatment, and incomplete KD adds a dimension to this complexity. While there are guidelines available for diagnosis, including clinical and echocardiographic findings, there is no definitive laboratory test, given the still unclear etiology. The best treatment option for recalcitrant disease is also debatable, as are the factors for those at high risk for coronary dilation. Although scoring systems are now available to risk stratify, these have variable success.
Conclusions: From the first description of KD in 1967, we now know better how to detect, treat and follow up its complications. It is envisaged that with rapid advances in research and collaborative work among physicians in this field, that we will be even better equipped with knowledge to risk-stratify, diagnose and manage KD, especially the incomplete and complex variants, in achieving better outcomes.},
issn = {2617-5428}, url = {https://pm.amegroups.org/article/view/4767}
}