710
Views
28
CrossRef citations to date
0
Altmetric
Review

Kawasaki disease: characteristics, diagnosis, and unusual presentations

, , ORCID Icon, &
Pages 1089-1104 | Received 20 Jun 2019, Accepted 21 Aug 2019, Published online: 01 Oct 2019

References

  • Singh S, Vignesh P, Burgner D. The epidemiology of Kawasaki disease: a global update. Arch Dis Child. 2015;100(11):1084–1088.
  • McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135(17):e927–99.
  • Pilania RK, Bhattarai D, Singh S. Controversies in diagnosis and management of Kawasaki disease. World J Clin Pediatr. 2018;7(1):27–35.
  • Kawasaki T, Singh S. Kawasaki disease - the journey over 50 years: 1967–2017. Int J Rheum Dis. 2018;21(1):7–9.
  • Singh S, Newburger JW, Kuijpers T, et al. Management of Kawasaki disease in resource-limited settings. Pediatr Infect Dis J. 2015;34(1):94–96.
  • Singh S, Sharma A, Jiao F. Kawasaki disease: issues in diagnosis and treatment–a developing country perspective. Indian J Pediatr. 2016;83(2):140–145.
  • Singh S, Jindal AK, Pilania RK. Diagnosis of Kawasaki disease. Int J Rheum Dis. 2018;21(1):36–44.
  • Makino N, Nakamura Y, Yashiro M, et al. Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015–2016. Pediatr Int. 2019;61(4):397–403.
  • Manlhiot C, Christie E, McCrindle BW, et al. Complete and incomplete Kawasaki disease: two sides of the same coin. Eur J Pediatr. 2012 Apr;171(4):657–662.
  • Maric LS, Knezovic I, Papic N, et al. Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience. Rheumatol Int. 2015;35(6):1053–1058.
  • Shivalingam G, Prashanth GP, Hebbal K, et al. Clinical presentation and cardiovascular outcome in complete versus incomplete Kawasaki disease. Indian Pediatr. 2017;54(10):844–847.
  • Aljishi FM, Alsinan A, Almadan B, et al. Diagnosing incomplete Kawasaki disease. Saudi J Med Med Sci. 2018;6(3):172–173.
  • Gorczyca D, Postępski J, Olesińska E, et al. The clinical profile of Kawasaki disease of children from three Polish centers: a retrospective study. Rheumatol Int. 2014;34(6):875–880.
  • Gorrab AA, Fournier A, Bouaziz AA, et al. Incidence rate and epidemiological and clinical aspects of Kawasaki disease in children of Maghrebi origin in the province of Quebec, Canada, compared to the country of origin. Glob Pediatr Health. 2016;3:2333794X16630670.
  • Basha A, Rawat A, Jindal AK, et al. Autoantibody profile in children with Kawasaki disease on long-term follow-up: A prospective study from North India. Int J Rheum Dis. 2018;21(11):2036–2040.
  • Perrin L, Letierce A, Guitton C, et al. Comparative study of complete versus incomplete Kawasaki disease in 59 pediatric patients. Joint Bone Spine Rev Rhum. 2009;76(5):481–485.
  • Reddy M, Singh S, Rawat A, et al. Pro-brain natriuretic peptide (ProBNP) levels in North Indian children with Kawasaki disease. Rheumatol Int. 2016;36(4):551–559.
  • Cho SY, Kim Y, Cha S-H, et al. Adjuvant laboratory marker of Kawasaki disease; NT-pro-BNP or hs-CRP? Ann Clin Lab Sci. 2011;41(4):360–363.
  • Lin K-H, Chang -S-S, Yu C-W, et al. Usefulness of natriuretic peptide for the diagnosis of Kawasaki disease: a systematic review and meta-analysis. BMJ Open. 2015;5(4):e006703–e006703.
  • Dionne A, Meloche-Dumas L, Desjardins L, et al. N-terminal pro-B-type natriuretic peptide diagnostic algorithm versus American Heart Association algorithm for Kawasaki disease. Pediatr Int Off J Jpn Pediatr Soc. 2017;59(3):265–270.
  • Kuo H-C, Hsieh K-S, Ming-Huey Guo M, et al. Next-generation sequencing identifies micro-RNA-based biomarker panel for Kawasaki disease. J Allergy Clin Immunol. 2016;138(4):1227–1230.
  • Singh S, Agarwal S, Bhattad S, et al. Kawasaki disease in infants below 6 months: a clinical conundrum? Int J Rheum Dis. 2016;19(9):924–928.
  • Salgado AP, Ashouri N, Berry EK, et al. High risk of coronary artery aneurysms in infants younger than 6 months of age with Kawasaki disease. J Pediatr. 2017;185:112–116.e1.
  • Chang F-Y, Hwang B, Chen S-J, et al. Characteristics of Kawasaki disease in infants younger than six months of age. Pediatr Infect Dis J. 2006;25(3):241–244.
  • Satoh K, Wakejima Y, Gau M, et al. Risk of coronary artery lesions in young infants with Kawasaki disease: need for a new diagnostic method. Int J Rheum Dis. 2018;21(3):746–754.
  • Han C-L, Zhao S-L. Intravenous immunoglobulin gamma (IVIG) versus IVIG plus infliximab in young children with Kawasaki disease. Med Sci Monit Int Med J Exp Clin Res. 2018;24:7264–7270.
  • Pilania RK, Jindal AK, Guleria S, et al. An update on treatment of Kawasaki disease. Curr Treat Options Rheumatol. 2019;5(1):36–55.
  • Yoon YM, Yun HW, Kim SH. Clinical characteristics of Kawasaki disease in infants younger than six months: a single-center study. Korean Circ J. 2016;46(4):550–555.
  • Kwak JH, Lee J, Ha KS. Significance of differential characteristics in infantile Kawasaki disease. Korean Circ J. 2019;49(8):755–765.
  • Manlhiot C, Yeung RSM, Clarizia NA, et al. Kawasaki disease at the extremes of the age spectrum. Pediatrics. 2009 Sep;124(3):e410–415.
  • Advani N, Santoso LA, Sastroasmoro S. Profile of Kawasaki disease in adolescents: is it different? Acta Med Indones. 2019;51(1):42–46.
  • Gomard-Mennesson E, Landron C, Dauphin C, et al. Kawasaki disease in adults: report of 10 cases. Medicine (Baltimore). 2010;89(3):149–158.
  • Unrod M, Smith M, Spring B, et al. Randomized controlled trial of a computer-based, tailored intervention to increase smoking cessation counseling by primary care physicians. J Gen Intern Med. 2007;22(4):478.
  • Tomiyama J, Hasegawa Y, Kumagai Y, et al. Acute febrile mucocutaneous lymph node syndrome (Kawasaki disease) in adults: case report and review of the literature. Jpn J Med. 1991;30(3):285–289.
  • Sève P, Stankovic K, Smail A, et al. Adult Kawasaki disease: report of two cases and literature review. Semin Arthritis Rheum. 2005;34(6):785–792.
  • Jindal AK, Pilania RK, Suri D, et al. An adult with fever and facial nerve palsy: an unusual presentation of Kawasaki disease. J Clin Rheumatol. 2019. (Epub ahead of print). DOI:10.1097/RHU.0000000000001024.
  • Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110(17):2747–2771.
  • Terasawa K, Ichinose E, Matsuishi T, et al. Neurological complications in Kawasaki disease. Brain Dev. 1983;5(4):371–374.
  • Stowe RC. Facial nerve palsy, Kawasaki disease, and coronary artery aneurysm. Eur J Paediatr Neurol. 2015;19(5):607–609.
  • Emiroglu M, Alkan G, Kartal A, et al. Abducens nerve palsy in a girl with incomplete Kawasaki disease. Rheumatol Int. 2016;36(8):1181–1183.
  • Thapa R, Mallick D, Biswas B, et al. Transient unilateral oculomotor palsy and severe headache in childhood Kawasaki disease. Rheumatol Int. 2011;31(1):97–99.
  • Ghosh A, Chakrabartty S, Niyogi P, et al. Kawasaki disease with palatal palsy. Indian Pediatr. 2000;37(11):1266–1268.
  • Wurzburger BJ, Avner JR. Lateral rectus palsy in Kawasaki disease. Pediatr Infect Dis J. 1999;18(11):1029–1031.
  • NR de M A, de Magalhães CMR, de FR Almeida R, et al. Prospective study of Kawasaki disease complications: review of 115 cases. Rev Assoc Medica Bras. 2011;57(3):295–300.
  • Magalhães CMR, Magalhães Alves NR, Oliveira KMA, et al. Sensorineural hearing loss: an underdiagnosed complication of Kawasaki disease. J Clin Rheumatol. 2010;16(7):322–325.
  • Novo A, Pinto S, Prior AC, et al. Kawasaki disease and sensorineural hearing loss: an (un)expected complication. Eur J Pediatr. 2012;171(5):851–854.
  • Smith KA, Yunker WK. Kawasaki disease is associated with sensorineural hearing loss: a systematic review. Int J Pediatr Otorhinolaryngol. 2014;78(8):1216–1220.
  • Binnetoglu A, Baglam T, Demir B, et al. Association between atypical/incomplete Kawasaki disease and sensorineural hearing loss: a case report. Clin Pediatr (Phila). 2016;55(4):380–383.
  • Park SY, Kim YH, Kim YH, et al. Sensorineural hearing loss in patients with Kawasaki disease. Korean J Pediatr. 2015;58(11):434–439.
  • Prangwatanagul W, Limsuwan A. Ischemic stroke in Kawasaki disease. Pediatr Int Off J Jpn Pediatr Soc. 2017;59(1):92–96.
  • Nikkhah A. Atypical Kawasaki disease presenting with hemiparesis and aphasia: a case report. Iran J Med Sci. 2018;43(1):86–89.
  • Dhawan SR, Vaidya PC, Suri D, et al. Infantile Kawasaki disease presenting as acute meningoencephalitis. Int J Rheum Dis. 2017;20(12):2225–2226.
  • Husain E, Hoque E. Meningoencephalitis as a presentation of Kawasaki disease. J Child Neurol. 2006;21(12):1080–1081.
  • Watanabe T. Pyuria in patients with Kawasaki disease. World J Clin Pediatr. 2015;4(2):25–29.
  • Pilania RK, Misra P, Guleria S, et al. Kawasaki disease presenting as fever and urinary tract infection. J Clin Rheumatol. 2018. [Epub ahead of print]. DOI:10.1097/RHU.0000000000000955.
  • Watanabe T. Clinical features of acute kidney injury in patients with Kawasaki disease. World J Clin Pediatr. 2018;7(3):83–88.
  • Tiewsoh K, Sharma D, Jindal AK, et al. Acute kidney injury in Kawasaki disease: report of 3 cases from North India and a brief review of literature. J Clin Rheumatol. 2018;24(4):231–234.
  • Jindal AK, Indla RT, Pilania RK, et al. Non-exudative conjunctival injection with limbal sparing: a pathognomonic clinical sign of Kawasaki disease. J Clin Rheumatol. 2018. Epub ahead of print. DOI:10.1097/RHU.0000000000000883.
  • Lee KJ, Kim HJ, Kim MJ, et al. Usefulness of anterior uveitis as an additional tool for diagnosing incomplete Kawasaki disease. Korean J Pediatr. 2016;59(4):174–177.
  • Choi HS, Lee SB, Kwon JH, et al. Uveitis as an important ocular sign to help early diagnosis in Kawasaki disease. Korean J Pediatr. 2015;58(10):374–379.
  • Kadyan A, Choi J, Headon MP. Disciform keratitis and optic disc swelling in Kawasaki disease: an unusual presentation. Eye Lond Engl. 2006;20(8):976–977.
  • Agarwal S, Mulkutkar S, Suri D, et al. Retinal vasculitis in Kawasaki disease. Indian J Pediatr. 2015;82(12):1183–1184.
  • Lin H, Burton EM, Felz MW. Orbital myositis due to Kawasaki’s disease. Pediatr Radiol. 1999;29(8):634–636.
  • Font RL, Mehta RS, Streusand SB, et al. Bilateral retinal ischemia in Kawasaki disease. Postmortem findings and electron microscopic observations. Ophthalmology. 1983;90(5):569–577.
  • Gao Y, Zhang Y, Lu F, et al. Rare ocular manifestations in an 11-year-old girl with incomplete Kawasaki disease: A case report. Medicine (Baltimore). 2018;97(22):e10974.
  • Agarwal S, Gupta A, Suri D, et al. Proximal muscle weakness in a child with Kawasaki disease. Indian J Pediatr. 2015;82(9):866.
  • Peng Y, Liu X, Duan Z, et al. Prevalence and characteristics of arthritis in Kawasaki disease: a Chinese cohort study. Clin Exp Med. 2019;19(2):167–172.
  • Martins A, Conde M, Brito M, et al. Arthritis in Kawasaki disease: A poorly recognised manifestation. J Paediatr Child Health. 2018;54(12):1371–1374.
  • Gong GWK, McCrindle BW, Ching JC, et al. Arthritis presenting during the acute phase of Kawasaki disease. J Pediatr. 2006;148(6):800–805.
  • Komatsu H, Tateno A. Failure to distinguish systemic-onset juvenile idiopathic arthritis from incomplete Kawasaki disease in an infant. J Paediatr Child Health. 2007;43(10):707–709.
  • Sahin S, Adrovic A, Barut K, et al. Systemic-onset juvenile idiopathic arthritis or incomplete Kawasaki disease: a diagnostic challenge. Clin Exp Rheumatol. 2017;35 Suppl 104(2):10.
  • Rigante D, Valentini P, Onesimo R, et al. Incomplete Kawasaki syndrome followed by systemic onset-juvenile idiopathic arthritis mimicking Kawasaki syndrome. Rheumatol Int. 2010;30(4):535–539.
  • Jen M, Brucia LA, Pollock AN, et al. Cervical spine and temporomandibular joint arthritis in a child with Kawasaki disease. Pediatrics. 2006;118(5):e1569–1571.
  • Nozaki F, Kusunoki T, Tomoda Y, et al. Grisel syndrome as a complication of Kawasaki disease: a case report and review of the literature. Eur J Pediatr. 2013;172(1):119–121.
  • Lee EY, Oh JY, Chong CY, et al. A case of atypical Kawasaki disease with myositis. Glob Pediatr Health. 2015;2:2333794X15599649.
  • Koca T, Aslan N, Akaslan Kara A, et al. Kawasaki disease in a 9-year old girl presenting with febrile cholestasis: case report and review of literature. Int J Rheum Dis. 2018;21(11):2046–2049.
  • Botti M, Costagliola G, Consolini R. Typical Kawasaki disease presenting with pancreatitis and bilateral parotid gland involvement: a case report and literature review. Front Pediatr. 2018;6:90.
  • Fabi M, Corinaldesi E, Pierantoni L, et al. Gastrointestinal presentation of Kawasaki disease: A red flag for severe disease? PloS One. 2018;13(9):e0202658.
  • Colomba C, La Placa S, Saporito L, et al. Intestinal involvement in Kawasaki disease. J Pediatr. 2018;202:186–193.
  • Sun Q, Zhang J, Yang Y. Gallbladder hydrops associated with Kawasaki disease: a case report and literature review. Clin Pediatr (Phila). 2017;57(3):341–343.
  • Zulian F, Falcini F, Zancan L, et al. Acute surgical abdomen as presenting manifestation of Kawasaki disease. J Pediatr. 2003;142(6):731–735.
  • Magilavy DB, Speert DP, Silver TM, et al. Mucocutaneous lymph node syndrome: report of two cases complicated by gallbladder hydrops and diagnosed by ultrasound. Pediatrics. 1978;61(5):699–702.
  • Chen C-J, Huang F-C, Tiao -M-M, et al. Sonographic gallbladder abnormality is associated with intravenous immunoglobulin resistance in Kawasaki disease. Scientific World J. 2012;2012:485758.
  • Lone YA, Menon J, Menon P, et al. Kawasaki disease presenting as acute intestinal obstruction. J Indian Assoc Pediatr Surg. 2017;22(3):170–172.
  • Garnett GM, Kimball S, Melish ME, et al. Appendicitis as the presenting manifestation of Kawasaki disease. Pediatr Surg Int. 2014;30(5):549–552.
  • Singh S, Gupta A, Jindal AK, et al. Pulmonary presentation of Kawasaki disease-A diagnostic challenge. Pediatr Pulmonol. 2018;53(1):103–107.
  • Freeman AF, Crawford SE, Finn LS, et al. Inflammatory pulmonary nodules in Kawasaki disease. Pediatr Pulmonol. 2003;36(2):102–106.
  • Sengler C, Gaedicke G, Wahn U, et al. Pulmonary symptoms in Kawasaki disease. Pediatr Infect Dis J. 2004;23(8):782–784.
  • Uziel Y, Hashkes PJ, Kassem E, et al. “Unresolving pneumonia” as the main manifestation of atypical Kawasaki disease. Arch Dis Child. 2003;88(10):940–942.
  • Umezawa T, Saji T, Matsuo N, et al. Chest x-ray findings in the acute phase of Kawasaki disease. Pediatr Radiol. 1989;20(1–2):48–51.
  • Kanegaye JT, Wilder MS, Molkara D, et al. Recognition of a Kawasaki disease shock syndrome. Pediatrics. 2009;123(5):e783–789.
  • Gamez-Gonzalez LB, Moribe-Quintero I, Cisneros-Castolo M, et al. Kawasaki disease shock syndrome: Unique and severe subtype of Kawasaki disease. Pediatr Int. 2018;60(9):781–790.
  • Taddio A, Rossi ED, Monasta L, et al. Describing Kawasaki shock syndrome: results from a retrospective study and literature review. Clin Rheumatol. 2017;36(1):223–228.
  • Pilania RK, Jindal AK, Srikrishna VV, et al. Hypotension in a febrile child-beware of Kawasaki disease shock syndrome. J Clin Rheumatol. 2019. [Epub ahead of print]. DOI:10.1097/RHU.0000000000001002.
  • Dahdah N. Not just coronary arteritis, Kawasaki disease is a myocarditis, too. J Am Coll Cardiol. 2010;55(14):1507.
  • Dahdah N, Siles A, Fournier A, et al. Natriuretic peptide as an adjunctive diagnostic test in the acute phase of Kawasaki disease. Pediatr Cardiol. 2009;30(6):810–817.
  • Dionne A, Dahdah N. Myocarditis and Kawasaki disease. Int J Rheum Dis. 2018;21(1):45–49.
  • De Rosa G, Andreozzi L, Piastra M, et al. Acute myocarditis as a revealing clue of complete Kawasaki disease. Reumatismo. 2018;70(2):115–116.
  • Suga K, Inoue M, Ono A, et al. Early combined treatment with steroid and immunoglobulin is effective for serious Kawasaki disease complicated by myocarditis and encephalopathy. J Med Investig. 2016;63(1–2):140–143.
  • Sato T, Somura J, Maruo Y. Steroid pulse therapy for Kawasaki disease complicated with myocarditis. Indian Pediatr. 2016;53(11):1015–1016.
  • Ishiguro N, Takahashi Y. Kawasaki disease associated with idiopathic thrombocytopenic purpura. Eur J Pediatr. 1989;148(4):379.
  • Reardon JD, Jackson MA. Idiopathic thrombocytopenic purpura and Kawasaki disease: a common viral etiology? Pediatr Infect Dis J. 1988;7(5):367–368.
  • Hara T, Mizuno Y, Akeda H, et al. Thrombocytopenia: a complication of Kawasaki disease. Eur J Pediatr. 1988;147(1):51–53.
  • Nofech-Mozes Y, Garty B-Z. Thrombocytopenia in Kawasaki disease: a risk factor for the development of coronary artery aneurysms. Pediatr Hematol Oncol. 2003;20(8):597–601.
  • Muise A, Tallett SE, Silverman ED. Are children with Kawasaki disease and prolonged fever at risk for macrophage activation syndrome? Pediatrics. 2003;112(6 Pt 1):e495.
  • Cummings C, McCarthy P, van Hoff J, et al. Kawasaki disease associated with reactive hemophagocytic lymphohistiocytosis. Pediatr Infect Dis J. 2008;27(12):1116–1118.
  • Suresh N, Sankar J. Macrophage activation syndrome: a rare complication of incomplete Kawasaki disease. Ann Trop Paediatr. 2010;30(1):61–64.
  • Titze U, Janka G, Schneider EM, et al. Hemophagocytic lymphohistiocytosis and Kawasaki disease: combined manifestation and differential diagnosis. Pediatr Blood Cancer. 2009;53(3):493–495.
  • Doğan V, Karaaslan E, Özer S, et al. Hemophagocytosis in the acute phase of fatal Kawasaki disease in a 4 month-old girl. Balk Med J. 2016;33(4):470–472.
  • Hendricks M, Pillay S, Davidson A, et al. Kawasaki disease preceding haemophagocytic lymphohistiocytosis: challenges for developing world practitioners. Pediatr Blood Cancer. 2010;54(7):1023–1025.
  • Mukherjee D, Pal P, Kundu R, et al. Macrophage activation syndrome in Kawasaki disease. Indian Pediatr. 2014;51(2):148–149.
  • Wang W, Gong F, Zhu W, et al. Macrophage activation syndrome in Kawasaki disease: more common than we thought? Semin Arthritis Rheum. 2015;44(4):405–410.
  • Ogawa M, Hoshina T. Hemophagocytic lymphohistiocytosis prior to the diagnosis of Kawasaki disease. Indian Pediatr. 2015;52(1):78.
  • García-Pavón S, Yamazaki-Nakashimada MA, Báez M, et al. Kawasaki disease complicated with macrophage activation syndrome: a systematic review. J Pediatr Hematol Oncol. 2017;39(6):445–451.
  • Lin Y, Shi L, Deng Y-J, et al. Kawasaki disease shock syndrome complicated with macrophage activation syndrome in a 5-month old boy: A case report. Medicine (Baltimore). 2019;98(4):e14203.
  • Latino GA, Manlhiot C, Yeung RSM, et al. Macrophage activation syndrome in the acute phase of Kawasaki disease. J Pediatr Hematol Oncol. 2010;32(7):527–531.
  • Choi U-Y, Han S-B, Lee S-Y, et al. Should refractory Kawasaki disease be considered occult macrophage activation syndrome? Semin Arthritis Rheum. 2017;46(4):e17.
  • Han S-B, Lee S-Y, Jeong D-C, et al. Should 2016 Criteria for Macrophage Activation Syndrome be applied in children with Kawasaki disease, as well as with systemic-onset juvenile idiopathic arthritis?. Ann Rheum Dis. 2016;75(7):e44–e44.
  • Jinkawa A, Shimizu M, Nishida K, et al. Cytokine profile of macrophage activation syndrome associated with Kawasaki disease. Cytokine. 2019;119:52–56.
  • Yang G, Thompson D, Warren A. Late-appearing brachiocephalic aneurysm: an atypical vascular sequella of Kawasaki disease. Pediatr Cardiol. 2009;30(2):197–199.
  • Cura MA, Haskal ZJ, Weintraub J, et al. SIR 2004 film panel case: Systemic artery aneurysms in Kawasaki disease. J Vasc Interv Radiol. 2004;15(9):1009–1011.
  • Heran MKS, Hockley A. Multiple mirror-image peripheral arterial aneurysms in Kawasaki disease. Pediatr Cardiol. 2011;32(5):670–673.
  • Casadonte JR, Perez VM, Stapleton G, et al. Magnetic resonance angiography detection of vascular aneurysms in patients with Kawasaki disease and coronary artery aneurysms. World J Pediatr Congenit Heart Surg. 2010;1(3):393–396.
  • Su JT, Chung T, Kovalchin JP. Magnetic resonance imaging of coronary and systemic aneurysms in Kawasaki disease. Cardiol Young. 2004;14(2):198–199.
  • Coelho NH, Barreto P, Martins V, et al. Rare condition, unusual anatomy, elegant solution - an uncommon manifestation of Kawasaki disease. EJVES Short Rep. 2019;42:12–14.
  • Arunakumar P, Ayyappan A, Sivasubramonian S, et al. Peripheral arterial aneurysms in a toddler. Eur Heart J Cardiovasc Imaging. 2018;19(2):239.
  • Briceno-Medina M, Perez M, Waller BR, et al. Systemic and pulmonary artery aneurysms in incomplete Kawasaki disease. J Cardiol Cases. 2016;13(6):185–188.
  • Hoshino S, Tsuda E, Yamada O. Characteristics and fate of systemic artery aneurysm after Kawasaki disease. J Pediatr. 2015;167(1):108–112.
  • Takahashi K, Oharaseki T, Yokouchi Y, et al. Kawasaki disease as a systemic vasculitis in childhood. Ann Vasc Dis. 2010;3(3):173–181.
  • Nitsure MY, Hiremath MS, Grant PK, et al. Kawasaki syndrome with multiple arterial aneurysms. Indian Pediatr. 1988;25(9):881–888.
  • Jiang L-C, Cao J-Y, Chen M. Coronary artery aneurysm combined with other multiple aneurysms at multiple locations: A case report and systematic review. Medicine (Baltimore). 2017;96(50):e9230.
  • Lee AM, Shimizu C, Oharaseki T, et al. Role of TGF-β signaling in remodeling of noncoronary artery aneurysms in Kawasaki disease. Pediatr Dev Pathol. 2015;18(4):310–317.
  • Foster BJ, Bernard C, Drummond KN. Kawasaki disease complicated by renal artery stenosis. Arch Dis Child. 2000;83(3):253–255.
  • Brenner JL, Jadavji T, Pinto A, et al. Severe Kawasaki disease in infants: two fatal cases. Can J Cardiol. 2000;16(8):1017–1023.
  • von Planta M, Fasnacht M, Holm C, et al. Atypical Kawasaki disease with peripheral gangrene and myocardial infarction: therapeutic implications. Eur J Pediatr. 1995;154(10):830–834.
  • Malekzadeh I, Ziaee V, Sadrosadat T, et al. Kawasaki disease and peripheral gangrene in infancy. Iran J Pediatr. 2015;25(6):e3309.
  • Krohn C, Till H, Haraida S, et al. Multiple intestinal stenoses and peripheral gangrene: a combination of two rare surgical complications in a child with Kawasaki disease. J Pediatr Surg. 2001;36(4):651–653.
  • Yamazaki-Nakashimada MA, Espinosa-Lopez M, Hernandez-Bautista V, et al. Catastrophic Kawasaki disease or juvenile Polyarteritis nodosa? Semin Arthritis Rheum. 2006;35(6):349–354.
  • Durall AL, Phillips JR, Weisse ME, et al. Infantile Kawasaki disease and peripheral gangrene. J Pediatr. 2006;149(1):131–133.
  • Dogan OF, Kara A, Devrim I, et al. Peripheral gangrene associated with Kawasaki disease and successful management using prostacycline analogue: a case report. Heart Surg Forum. 2007;10(1):E70–72.
  • O’connor MJ, Saulsbury FT. Incomplete and atypical Kawasaki disease in a young infant: severe, recalcitrant disease responsive to infliximab. Clin Pediatr (Phila). 2007;46(4):345–348.
  • Kim NY, Choi DY, Jung MJ, et al. A case of refractory Kawasaki disease complicated by peripheral ischemia. Pediatr Cardiol. 2008;29(6):1110–1114.
  • Gomez-Moyano E, Vera Casaño A, Camacho J, et al. Kawasaki disease complicated by cutaneous vasculitis and peripheral gangrene. J Am Acad Dermatol. 2011;64(5):e74–75.
  • Krishnamurthy S, Jagadeesh A, Chandrasekaran V, et al. Haemolytic uraemic syndrome with peripheral gangrene and Kawasaki disease in a 15-month-old child. Paediatr Int Child Health. 2017;37(1):70–73.
  • Tomita S, Chung K, Mas M, et al. Peripheral gangrene associated with Kawasaki disease. Clin Infect Dis. 1992;14(1):121–126.
  • Bonté I, Mahr A, Laroche L, et al. Peripheral gangrene in adult-onset Kawasaki disease. Scand J Rheumatol. 2005;34(1):71–73.
  • Sudo D, Nakamura Y. Nationwide surveys show that the incidence of recurrent Kawasaki disease in Japan has hardly changed over the last 30 years. Acta Paediatr Oslo Nor. 2017;106(5):796–800.
  • Lee HJ, Cho AR, Kim HS, et al. Clinical characteristics of recurrent Kawasaki disease. Korean J Pediatr. 2004;47(8):879–883.
  • Maddox RA, Holman RC, Uehara R, et al. Recurrent Kawasaki disease: USA and Japan. Pediatr Int Off J Jpn Pediatr Soc. 2015;57(6):1116–1120.
  • Chahal N, Somji Z, Manlhiot C, et al. Rate, associated factors and outcomes of recurrence of Kawasaki disease in Ontario, Canada. Pediatr Int. 2012;54(3):383–387.
  • Guleria S, Pilania RK, Jindal AK, et al. Recurrent Kawasaki disease at a tertiary care center in Chandigarh, North West India: 24 years of clinical experience. Int J Rheum Dis. 2019;22(7):1183–1187.
  • Huang Y-H, Lin K-M, Ho S-C, et al. Increased Incidence of Kawasaki Disease in Taiwan in Recent Years: A 15 Years Nationwide Population-Based Cohort Study. Front Pediatr. 2019;7:121.
  • Goswami N, Marzan K, De Oliveira E, et al. Recurrent Kawasaki disease: a case report of three separate episodes at >4-year intervals. Child Basel Switz. 2018;5:11.
  • Nakamura Y, Oki I, Tanihara S, et al. Cardiac sequelae in recurrent cases of Kawasaki disease: a comparison between the initial episode of the disease and a recurrence in the same patients. Pediatrics. 1998;102(6):E66.
  • Zou L-X, Gong F-Q. Clinical features of recurrent Kawasaki disease in 20 children. Zhongguo Dang Dai Er Ke Za Zhi. 2008;10(5):617–619.
  • Michie C, Kinsler V, Tulloh R, et al. Recurrent skin peeling following Kawasaki disease. Arch Dis Child. 2000;83(4):353–355.
  • Parmar RC, Somale A, Bavdekar SB, et al. Incomplete Kawasaki disease with recurrent skin peeling: a case report with the review of literature. J Postgrad Med. 2003;49(1):72–74.
  • Kubota M, Usami I, Yamakawa M, et al. Kawasaki disease with lymphadenopathy and fever as sole initial manifestations. J Paediatr Child Health. 2008;44(6):359–362.
  • Nomura Y, Arata M, Koriyama C, et al. A severe form of Kawasaki disease presenting with only fever and cervical lymphadenopathy at admission. J Pediatr. 2010;156(5):786–791.
  • Harris KC, Hosking MCK. Persistent fever in an infant: incomplete Kawasaki disease. CMAJ Can Med Assoc J. 2011;183(17):2009–2013.
  • Pinches H, Dobbins K, Cantrell S, et al. Asymptomatic Kawasaki disease in a 3-month-old infant. Pediatrics. 2016;138:2.
  • Hinze CH, Graham TB, Sutherell JS. Kawasaki disease without fever. Pediatr Infect Dis J. 2009;28(10):927–928.
  • Vignesh P, Bhattad S, Singhal M, et al. A 5-year-old boy with only fever and giant coronary aneurysms: the enigma of Kawasaki disease? Rheumatol Int. 2016;36(8):1191–1193.
  • Ayusawa M, Sonobe T, Uemura S, et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int. 2005;47(2):232–234.
  • Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis. 2006;65(7):936–941.
  • Rezai MS, Shahmohammadi S. Erythema at BCG inoculation site in Kawasaki disease patients. Mater Socio Medica. 2014;26(4):256–260.
  • Pal P, Giri PP. Orange-brown chromonychia, a novel finding in Kawasaki disease. Rheumatol Int. 2013;33(5):1207–1209.
  • Yamazaki-Nakashimada MA, Deguchi K, Gámez-González B, et al. Orange-brown chromonychia: A valid sign in Kawasaki disease in children of different ethnicities. Int J Rheum Dis. 2019;22(6):1160–1161.
  • Guleria S, Bhattarai D, Pilania RK, et al. Koplik spots: a physical finding that should never be missed in children with suspected Kawasaki disease. J Clin Rheumatol. 2018. Epub ahead of print. DOI:10.1097/RHU.0000000000000855.
  • Buonsenso D, Macchiarulo G, Supino MC, et al. Laboratory biomarkers to facilitate differential diagnosis between measles and Kawasaki disease in a pediatric emergency room: a retrospective study. Mediterr J Hematol Infect Dis. 2018;10:1.
  • Binstadt BA, Levine JC, Nigrovic PA, et al. Coronary artery dilation among patients presenting with systemic-onset juvenile idiopathic arthritis. Pediatrics. 2005;116(1):e89–93.
  • Yeung Rae S, van Veenendaal M, Cedric M, et al. Abstract O.36: Kawasaki disease and systemic juvenile idiopathic arthritis - two ends of the same spectrum. Circulation. 2015;131(suppl_2):AO36.
  • Singh S, Gupta D, Suri D, et al. Thrombocytopenia as a presenting feature of Kawasaki disease: a case series from North India. Rheumatol Int. 2009;30(2):245–248.
  • Choi JY, Park SY, Choi KH, et al. Clinical characteristics of Kawasaki disease with sterile pyuria. Korean J Pediatr. 2013;56(1):13–18.
  • Dominguez SR, Martin B, Heizer H, et al. Procalcitonin (PCT) and Kawasaki disease: does PCT correlate with IVIG-resistant disease, admission to the intensive care unit, or development of coronary artery lesions? J Pediatr Infect Dis Soc. 2016;5(3):297–302.
  • McCrindle BW, Cifra B. The role of echocardiography in Kawasaki disease. Int J Rheum Dis. 2018;21(1):50–55.
  • Manlhiot C, Millar K, Golding F, et al. Improved classification of coronary artery abnormalities based only on coronary artery z-scores after Kawasaki disease. Pediatr Cardiol. 2010;31(2):242–249.
  • McCrindle BW, Li JS, Minich LL, et al. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007;116(2):174–179.
  • Dallaire F, Dahdah N. New equations and a critical appraisal of coronary artery Z scores in healthy children. J Am Soc Echocardiogr. 2011;24(1):60–74.
  • Kobayashi T, Fuse S, Sakamoto N, et al. A new Z score curve of the coronary arterial internal diameter using the Lambda-Mu-Sigma method in a pediatric population. J Am Soc Echocardiogr. 2016;29(8):794–801.e29.
  • Son Mary Beth F, Kimberlee G, Susan K, et al. Predicting coronary artery aneurysms in Kawasaki disease at a North American center: an assessment of baseline z scores. J Am Heart Assoc. 2017;6(6):e005378.
  • Ronai C, Hamaoka-Okamoto A, Baker AL, et al. Coronary artery aneurysm measurement and Z score variability in Kawasaki disease. J Am Soc Echocardiogr. 2016;29(2):150–157.
  • Muniz J-CG, Dummer K, Gauvreau K, et al. Coronary artery dimensions in febrile children without Kawasaki disease. Circ Cardiovasc Imaging. 2013;6(2):239–244.
  • Singhal M, Singh S, Gupta P, et al. Computed tomography coronary angiography for evaluation of children with Kawasaki disease. Curr Probl Diagn Radiol. 2018;47(4):238–244.
  • Singhal M, Gupta P, Singh S, et al. Computed tomography coronary angiography is the way forward for evaluation of children with Kawasaki disease. Glob Cardiol Sci Pract. 2017;2017(3):e201728.
  • Tsuda E, Singhal M. Role of imaging studies in Kawasaki disease. Int J Rheum Dis. 2018;21(1):56–63.
  • Park BS, Bang MH, Kim SH. Imaging and clinical data distinguish lymphadenopathy-first-presenting Kawasaki disease from bacterial cervical lymphadenitis. J Cardiovasc Imaging. 2018;26(4):238–246.
  • Parihar M, Singh S, Vignesh P, et al. Mid-term risk for subclinical atherosclerosis and chronic myocarditis in children with Kawasaki disease and transient coronary abnormalities. Pediatr Cardiol. 2017;38(6):1123–1132.
  • Noto N, Komori A, Ayusawa M, et al. Recent updates on echocardiography and ultrasound for Kawasaki disease: beyond the coronary artery. Cardiovasc Diagn Ther. 2018;8(1):80–89.
  • Rawat A, Singh S. Biomarkers for diagnosis of kawasaki disease. Indian Pediatr. 2015;52(6):473–474.
  • Chaudhary H, Nameirakpam J, Kumrah R, et al. Biomarkers for Kawasaki disease: clinical utility and the challenges ahead. Front Pediatr. 2019;7:242.
  • Zhang L, Jia H-L, Huang W-M, et al. Monitoring of the serum proteome in Kawasaki disease patients before and after immunoglobulin therapy. Biochem Biophys Res Commun. 2014;447(1):19–25.
  • Lech M, Guess J, Duffner J, et al. Circulating markers of inflammation persist in children and adults with giant aneurysms after Kawasaki disease. Circ Genomic Precis Med. 2019;12(4):e002433.
  • Yu H-R, Kuo H-C, Sheen J-M, et al. A unique plasma proteomic profiling with imbalanced fibrinogen cascade in patients with Kawasaki disease. Pediatr Allergy Immunol. 2009;20(7):699–707.
  • Kuo H-C, Wang C-L, Yang KD, et al. Plasma prostaglandin E2 levels correlated with the prevention of intravenous immunoglobulin resistance and coronary artery lesions formation via CD40L in Kawasaki disease. PloS One. 2016;11(8):e0161265.
  • Tseng W-N, Lo M-H, Guo MM-H, et al. IL-31 associated with coronary artery lesion formation in Kawasaki disease. PloS One. 2014;9(8):e105195.
  • Kuo H-C, Huang Y-H, Chung F-H, et al. Antibody profiling of Kawasaki disease using escherichia coli proteome microarrays. Mol Cell Proteomics MCP. 2018;17(3):472–481.
  • Kentsis A, Shulman A, Ahmed S, et al. Urine proteomics for discovery of improved diagnostic markers of Kawasaki disease. EMBO Mol Med. 2013;5(2):210–220.
  • Hu H, Du H, Cui J, et al. New biomarkers of Kawasaki disease identified by urine proteomic analysis. FEBS Open Bio. 2018 Dec 20;9(2):265–275.
  • Huang Y-H, Lo M-H, Cai X-Y, et al. Epigenetic hypomethylation and upregulation of NLRC4 and NLRP12 in Kawasaki disease. Oncotarget. 2018;9(27):18939–18948.
  • Kuo H-C, Li S-C, Huang L-H, et al. Epigenetic hypomethylation and upregulation of matrix metalloproteinase 9 in Kawasaki disease. Oncotarget. 2017;8(37):60875–60891.
  • Kone-Paut I, Cimaz R, Herberg J, et al. The use of interleukin 1 receptor antagonist (anakinra) in Kawasaki disease: A retrospective cases series. Autoimmun Rev. 2018;17(8):768–774.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.