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Variation in the management of Kawasaki disease
- Source :
- Archives of Disease in Childhood. 105:1004-1006
- Publication Year :
- 2019
- Publisher :
- BMJ, 2019.
-
Abstract
- Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.
- Subjects :
- Male
medicine.medical_specialty
Drug Resistance
Specialty
Drug resistance
Mucocutaneous Lymph Node Syndrome
Tumour necrosis factor alpha
Pediatrics
03 medical and health sciences
0302 clinical medicine
Aneurysm
Coronary Aneurysms
Surveys and Questionnaires
hemic and lymphatic diseases
030225 pediatrics
Internal medicine
medicine
Humans
Immunologic Factors
Initial treatment
In patient
Practice Patterns, Physicians'
Glucocorticoids
Tumor Necrosis Factor-alpha
business.industry
Coronary Aneurysm
Immunoglobulins, Intravenous
medicine.disease
Pediatrics, Perinatology and Child Health
Female
Kawasaki disease
business
Subjects
Details
- ISSN :
- 14682044 and 00039888
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- Archives of Disease in Childhood
- Accession number :
- edsair.doi.dedup.....f2b9fc3956a18e35e001647a7fe13b3f