title: Kawasaki Disease.
abstract: Kawasaki disease is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in infants and children. If not treated early with high-dose intravenous immunoglobulin, 1 in 5 children develop coronary artery aneurysms; this risk is reduced 5-fold if intravenous immunoglobulin is administered within 10 days of fever onset. Coronary artery aneurysms evolve dynamically over time, usually reaching a peak dimension by 6 weeks after illness onset. Almost all the morbidity and mortality occur in patients with giant aneurysms. Risk of myocardial infarction from coronary artery thrombosis is greatest in the first 2 years after illness onset. However, stenosis and occlusion progress over years. Indeed, Kawasaki disease is no longer a rare cause of acute coronary syndrome presenting in young adults. Both coronary artery bypass surgery and percutaneous intervention have been used to treat Kawasaki disease patients who develop myocardial ischemia as a consequence of coronary artery aneurysms and stenosis.
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: jane.newburger@cardio.chboston.org.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Newburger
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital and University of Washington School of Medicine, Seattle, Washington.
authors.forename: Masato
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics, Rady Children's Hospital, University of California-San Diego, School of Medicine, La Jolla, California.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Burns
mesh_terms: D056704:Adaptive Immunity; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003323:Coronary Aneurysm / Q000517:prevention & control; D003328:Coronary Thrombosis / Q000517:prevention & control; D003952:Diagnostic Imaging; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007113:Immunity, Innate; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009043:Motor Activity; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D017202:Myocardial Ischemia / Q000517:prevention & control; D009204:Myocardial Revascularization; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D001241:Aspirin
keywords: aneurysm; coronary aneurysm; coronary thrombosis; immunoglobulin; intravenous; mucocutaneous lymph node syndrome; myocardial infarction