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Background: Kawasaki disease (KD) is a pyretic ailment predominantly observed in children aged below 5 years. There is currently a dearth of precise markers for timely identification of incomplete Kawasaki disease (IKD). It is imperative to develop updated, comprehensive, and evidence-based guidelines to effectively direct clinical practice., Methods: The guideline development group comprised individuals with diverse expertise in both content and methodology and carried out an extensive exploration of the following digital repositories: CNKI, VIP, Wanfang Data, UpToDate, BMJ, Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed. The entire period from the establishment of these databases until January 1, 2024 was covered. To evaluate IKD, systematic reviews and randomised controlled trials were assessed using the risk of prejudice instrument specified in the Cochrane Handbook, along with the evidence robustness framework established by the GRADE group. The recommendations were formulated based on the findings, considering the evidence strength. After several iterations of expert consensus, the relevant professional committees in China endorsed the ultimate guideline., Results: These guidelines address clinical questions regarding the classification and definition of KD, diagnosis of IKD, treatment during the acute phase of IKD, and follow-up of IKD., Conclusions: To provide healthcare professionals with guidance and decision-making bases for the diagnosis and treatment of IKD in China, 13 recommendations were formulated based on expert consensus and evidence of best practices., (© 2024. The Author(s).)

Aim: The relationship between vitamin D status and Kawasaki Disease (KD), as well as coronary artery lesion (CAL), has yet to be established., Methods: A meta-analysis was conducted to assess the correlation between vitamin D status and KD, as well as the impact of vitamin D status on the progression of KD into CAL., Results: The meta-analysis revealed a consistent and significant association between serum 25(OH)D level and the occurrence KD (studies N = 22; z = -3.51, P < 0.001). Patients with KD had markedly lower levels of vitamin D than healthy controls (SMD: -1.30 ng/mL, 95%CI: -2.05 to -0.55 ng/mL)., Conclusion: The study provided evidence supporting a significant association between lower serum vitamin D levels and the occurrence of KD, particularly within the Chinese population. However, the findings did not suggest a direct impact of vitamin D on the development of CAL in KD patients., (© 2024. The Author(s).)

Background: Kawasaki disease (KD) is a medium vessel vasculitis, of unknown etiology, typically presenting in children younger than 5 years of age. Prolonged fever (at least five days) is a major clinical criterion of KD, while cardiac involvement may occur in up to 25% of patients, generally in the second week of the disease., Case Presentation: We describe the case of KD developing in a 3-month infant, with an early occurrence of coronary artery aneurysm after only 3 days of fever, complicated by thrombosis, requiring aggressive treatments., Conclusions: Time of development of cardiac complications can be different in young infants with KD and both diagnostic criteria and treatment indications should be individualized in this class of age., (© 2023. The Author(s).)

Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.

To identify whether lymphocyte hydrogen sulfide production is a potential biomarker for predicting coronary artery lesions (CAL) in children with Kawasaki disease (KD). Eighty-six children with KD, 33 normal children and 43 children with fever from June 2016 to January 2019 in Shaanxi Provincial People's Hospital were enrolled. Of 86 KD patients, 16 patients exhibited CAL. Lymphocyte hydrogen sulfide production was significantly greater in KD patients (13.7 ± 2.7) nmol/min/108 lymphocytes than in the controls (9.26 ± 3.33) nmol/min/108 lymphocytes and the fever group (8.21 ± 2.77) nmol/min/108 lymphocytes. The lymphocyte hydrogen sulfide production was greater in CAL patients than the non-CAL patients [(16.24 ± 1.81) vs. (13.12 ± 2.58), p < 0.001]. Receiver operating characteristic curve indicated when the lymphocyte hydrogen sulfide production was >15.285 nmol/min/108 lymphocytes, the sensitivity and specificity for predicting CAL at convalescence were 87.5% and 82.9%, respectively. Lymphocyte hydrogen sulfide production in the acute period is a potentially useful biomarker for predicting CAL in KD children., (© The Author(s) [2019]. Published by Oxford University Press.)

The aim of the study was to identify whether lymphocyte hydrogen sulfide production is a potential biomarker to predict intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD).This preliminary, single-center, case-control study conducted between June 2016 and March 2018 in Shaanxi Provincial People's Hospital, 85 children (50 with KD and 35 healthy controls) were included. Laboratory biomarkers were collected from the medical records. All patients with KD received 1 g/kg/d IVIG for 2 days and 30-50 mg/kg/d oral aspirin. The aspirin dose was reduced from 3 to 5 mg/kg/d after body temperature normalized. Plasma hydrogen sulfide levels were detected using sulfide electrode. Lymphocyte hydrogen sulfide levels were detected using the human hydrogen sulfide ELISA kits at the acute stage.Of 50 patients with KD, 31 and 19 were diagnosed with complete KD (cKD) and incomplete KD (iKD), respectively. Eleven patients with KD were resistant to IVIG treatment. The laboratory biomarker findings and levels of plasma and lymphocyte hydrogen sulfide were significantly different between the patients with KD and control group (P < .001). Moreover, lymphocyte hydrogen sulfide production was significantly greater in IVIG-resistant patients than in the IVIG-responsive patients, both in cKD and iKD (P = .018 and P < .001 respectively). Receiver operating characteristic curve indicated that when the lymphocyte hydrogen sulfide production was >15.285 nmol/min/10 lymphocytes, the sensitivity and specificity for predicting IVIG resistance were 90.9% and 76.9%, respectively.Lymphocyte hydrogen sulfide production could serve as a predictor of the therapeutic efficacy of IVIG in children with KD.

Kawasaki disease (KD), also well known as mucocutaneous lymph node syndrome, is an acute febrile disease in children with systemic vasculitis as its main pathological change, and usually occurs in children under the age of 5. KD is now the commonest cause of acquired heart disease in children in Japan, Europe and North America. Although KD is now being increasingly diagnosed in mainland China, there is paucity of data on this condition. To provide clinical basis for the treatment of KD, the authors report their experience on 170 children with KD at Shaanxi People's Hospital, Xi'an, China in this research. This also is one of the largest single centre experiences from China so far.

Kawasaki disease (KD) or Kawasaki syndrome is known as a vasculitis of small to medium-sized vessels, and coronary arteries are predominantly involved in childhood. Generally, 20-25% of untreated with IVIG and 3-5% of treated KD patients have been developed coronary artery lesions (CALs), such as dilatation and aneurysm. Understanding how coronary artery aneurysms (CAAs) are established and maintained in KD patients is therefore of great importance. Upon our previous genotyping data of 157 valid KD subjects, a genome-wide association study (GWAS) has been conducted among 11 (7%) CAA-developed KD patients to reveal five significant genetic variants passed pre-defined thresholds and resulted in two novel susceptibility protein-coding genes, which are NEBL (rs16921209 (P = 7.44 × 10(-9); OR = 32.22) and rs7922552 (P = 8.43 × 10(-9); OR = 32.0)) and TUBA3C (rs17076896 (P = 8.04 × 10(-9); OR = 21.03)). Their known functions have been reported to associate with cardiac muscle and tubulin, respectively. As a result, this might imply their putative roles of establishing CAAs during KD progression. Additionally, various model analyses have been utilized to determine dominant and recessive inheritance patterns of identified susceptibility mutations. Finally, all susceptibility genes hit by significant genetic variants were further investigated and the top three representative gene-ontology (GO) clusters were regulation of cell projection organization, neuron recognition, and peptidyl-threonine phosphorylation. Our results help to depict the potential routes of the pathogenesis of CAAs in KD patients and will facilitate researchers to improve the diagnosis and prognosis of KD in personalized medicine.

Kawasaki disease (KD) is a common vasculitis in children and is the commonest cause of pediatric acquired heart disease in children in Japan and countries in North America and the European Union. It is now being increasingly reported from several developing countries, including China and India. Diagnosis of KD is based on a set of clinical criteria, none of which is individually pathognomonic for this condition. Further, these clinical features appear sequentially over a few days and all findings may not be present at a given point of time. Like many other vasculitides, there is no confirmatory laboratory test for KD. Treatment of KD involves use of intravenous immunoglobulin (IVIg) and aspirin. IVIg is an expensive product and poses several difficulties for patients in developing countries who may find it difficult to access therapy even if a diagnosis of KD has been made in time. In this review, the authors discuss some of these challenges that pediatricians have to face while managing KD in resource constrained settings.

The objective of this paper is to describe the epidemiological and clinical characteristics of Kawasaki disease (KD) in Shaanxi Province, China during the 5-year period from January 1993 to December 1997. A province-wide epidemiological survey on KD was made by the China-Japan Kawasaki Disease Study Group. The questionnaire form and the diagnostic criteria of KD, which were prepared by the Japan Kawasaki Disease Research Committee and translated into Chinese, were sent to the departments of pediatrics of all the hospitals with 100 beds or more in Shaanxi province. All the KD patients who were diagnosed during the observation period from 1993 to 1997 were asked to take part in this survey. The databases of reported KD in this survey were analysed at the Department of Pediatrics of the Shaanxi Provincial People's Hospital, Xi'an, China. All the patients that satisfied the diagnostic criteria were included in the report. A total of 105 (70 per cent) hospitals responded and 376 cases of KD were confirmed. More cases were reported in 1993 and 1994. Of the total patients reported, 69 per cent were children under 3 years old with a male to female ratio of 1.6:1. The proportion of patients with cardiac sequelae was 19 per cent with a male to female ratio of 3:1. There were four fatal cases with a fatality rate of 1 per cent. It is concluded that KD is common in China. Continuous surveillance is necessary to maintain high awareness of KD so as to find possible risk factors and their association with the disease.

Objective: The objective of this paper is to describe the epidemiological and clinical characteristics of Kawasaki disease (KD) in Shanxi province, China during a 5 year - period from January 1993 to December 1997., Methods: A province - wide epidemiological survey on Kawasaki disease (KD) was carried ont by the China - Japan Kawasaki disease study group. The questionnaire form and the diagnostic criteria of KD which was prepared by the Japan Kawasaki disease research committee and translated into Chinese were sent of the departments of pediatrics of all the hospitals with 100 or more beds in Shanxi province. All the KD patients who were diagnosed during the observation period from 1993 to 1997 were asked to report to this survey. The database of reported KD in this survey was analyzed at the Department of pediatrics of the Shanxi provincial people's hospital, Xian, China. All the patients that satisfied the diagnostic criteria were included., Results: A total of 105 (70%) hospitals responded and 376 cases of KD were confirmed. More cases were reported in 1993 and 1994. Of the total patients reported, 69% were children under 3 years old with male to female ratio of 1.6:1. The proportion of patients with cardiac sequelae was 19% with male to female ratio: 3:1. There were 4 fatal cases with a fatality rate of 1%., Conclusions: Since KD is common in China continuous surveillance is necessary to maintain high awareness of KD so as to identify possible risk factors and its association with other disease.