Recent developments and controversies in Kawasaki disease.
In the developed world, Kawasaki disease is currently the leading cause of pediatric acquired heart disease. To date, the etiologic agent remains unknown. Many hypotheses regarding the etiology exist, and debate continues as to whether the inflammatory response of Kawasaki disease results from a superantigen or a conventional antigen. A variety of growth factors, proteinases, and cytokines have been identified that are involved in the pathogenesis of coronary artery disease in Kawasaki disease. These findings are leading to novel treatment strategies in Kawasaki disease, including platelet glycoprotein receptor inhibitors and monoclonal antibody to tumor necrosis factor-alpha. The role of corticosteroids remains controversial, and ongoing clinical trials are evaluating its efficacy. Additional studies have focused on newer non-invasive methods of evaluating children with coronary artery disease as alternatives to coronary catheterization. We review recent developments and controversies in exploring the etiology, pathogenesis, diagnosis, and management of Kawasaki disease.
Guzman-Cottrill
J A
JA
Division of Infectious Diseases, Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Children's Memorial Hospital, Chicago, IL 60614, USA. jguzman@childrensmemorial.org
Shulman
S T
ST
D000893:Anti-Inflammatory Agents / Q000145:classification / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D018450:Disease Progression; D004334:Drug Administration Schedule; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D001241:Aspirin