PHN Publications

Associated Symptoms in the Ten Days Before Diagnosis of Kawasaki Disease (PDF), A. Baker, J Pediatrics 2009; 154(4):592-595.
Many children with Kawasaki disease (KD) have other symptoms that may lead to a delay in the diagnosis of KD. This study investigated common symptoms in children in the KD study (in addition to the symptoms of KD) in the 10 days before they were diagnosed with KD. Symptoms reported were irritability, vomiting, decrease in food/fluid intake, coughing, diarrhea, runny nose, weakness, stomach pain, and joint pain. Symptoms of KD can often be accompanied by symptoms commonly found in other common childhood illnesses. Clinicians should consider the diagnosis of KD, even when other common symptoms are present.

Coronary Artery Involvement in Children with Kawasaki Disease: Risk Factors from Analysis of Serial Normalized Measurements (PDF), B. McCrindle, Circulation 2007; 116:1-6.
This study looked at how coronary artery size changes during when a child has Kawasaki Disease (KD) by performing echocardiograms at the time of diagnosis, at one week and five weeks after diagnosis. The results showed that, in most patients, the coronary arteries are most dilated at the time of diagnosis of KD and they decrease in size over time. The KD study also showed that aneurysms (bulges or outpouches) in the coronary arteries were infrequent.

Delayed Diagnosis of Kawasaki Disease: What Are the Risk Factors? (PDF) L. Minich, Pediatrics December 2007; 120(6):e1434-40.
Late diagnosis of Kawasaki disease (KD) increases the risk that a child might have enlargement or aneurysms (out-pouching) of their coronary arteries. This study tried to see how many children in the KD study had a late diagnosis and what factors contributed to a late diagnosis. Being less than 6 months of age, living a greater distance from the hospital and having fewer symptoms (incomplete KD) increased the likelihood of late diagnosis.

Randomized Trial of Pulsed Corticosteroid Therapy for Primary Treatment of Kawasaki Disease (PDF), J. Newburger, NEJM 2007; 356(7):663-675.
Children with Kawasaki disease (KD) are at risk for developing aneurysms (out-pouchings) and enlargement of the coronary arteries, the arteries which bring blood and oxygen to the heart muscle itself.  Medications are used to reduce the risk of damage to the coronary arteries and to decrease inflammation. Yet, some children still develop aneurysms and coronary artery enlargement. This trial tested whether adding another type of medication (a corticosteroid) to the standard treatment of aspirin and immune globulin would decrease the amount of coronary artery dilation. The results did not support the use of a steroid in addition for the routine treatment of children with KD.