National consensus on the cardiological treatment and follow-up of Kawasaki disease

Kawasaki disease is a self-limiting acute vasculitis that affects small and medium-sized vessels, and is the most common cause of acquired heart disease in children in our environment. Up to 25% of untreated patients develop coronary aneurysms. It is suspected that an infectious agent may be the tri...

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Autores: Sombrero, HR, Fernandez-Cooke, E, Sanchez-Manubens, J, Picarzo, JPL, de la Torre, LA, Alvarez-Fuente, M, Garcia, GG, Gutierrez-Larraya, F, Vazquez, BT, McMullan, PD, Perez, GA, Arboledas, FJA, Martin, CA, Echauri, JA, Garcia, PA, Arevalo, P, Rofes, AA, Sanchez, MA, Domingo, EJB, Rodrigo, AB, Abbona, MSB, Fernandez, IB, Tascon, AB, Torralva, CMB, Jover, EB, Rodriguez, CB, Trigo, SB, Sayago, MJB, Diaz, MJC, Tejedor, MTC, Moreno, JIC, Blesa, CC, Bellon, JMC, Cassanello, MP, Malfaz, FC, Spoturno, ACC, Hernandez, RC, Orvay, JAC, Marcos, DC, Manotas, HAC, Peiro, VC, de Caro, AP, Cancho, MD, Iglesias, LAD, Bronte, LD, Menendez, BD, Megias, LD, Tomas, JJD, Colina, PD, Garcia, OD, Garrido, MND, Manzano, PD, Bedoya, JD, Espinosa, JE, Nava, FEE, Pinela, HDE, Asenjo, ME, Ruiz, APF, Aracama, JF, Sarabia, JF, Soria, MTF, Suarez, NF, Belda, AF, Villar, SF, Garcia, JF, Moure, AF, de Vinuesa, APGG, Arzoz, MG, Angleu, FG, Cerro, EG, Rodriguez-Monte, MEGL, Villanueva, NG, Crespo, MG, Carrasco, MEG, Marin, MAG, Menchen, CG, Ipina, FG, Rodriguez, IG, Esteve, MTG, Gomez, MH, Blanco, AH, Sanchez, YH, del Rey, CH, Fernandez, AI, Martin, GI, Fos, II, Riezu, MAI, Casso, MSJ, Montanes, LJ, de Lera, CL, Navarro, LL, Abel, BL, Balseiro, ML, Gonzalez, JL, Julian, NM, Cazcarra, JAM, Toral, MJM, Linero, AM, Garcia, BM, Llagaria, MM, Alonso, SM, Blanch, CM, de Lara, IM, del Villar, MM, Lorente, MIM, Oloron, PM, Soto, MIM, Checa, LM, Morillo, MAM, Lopez, CM, Abad, PM, Ortiz, FM, Gutierrez, AM, Tirado, AM, Montes, AO, Matamala, AO, Garrido, AO, Erroz, IO, Argueta, JRP, Aguera, LP, Molina, EP, Salas, JEP, Carrillo, CJP, Campos, DP, Herrera, VP, Agapito, MAPM, Munuzuri, AP, Pardo, AMP, Roldan, JMP, Picarzo, FJPL, Moreno, MRPP, Perin, F, Fuentes, IP, Izquierdo, BP, Morales, MP, Dalmau, MAP, Ovalle, EP, Poveda, MTR, Rodriguez, SR, Garcia, SMR, Arcelus, ER, Mendez, BR, Armada, AR, Jimenez, NR, Gonzalez, MR, Mesa, MDR, Serrano, RR, Sombrero, MHR, Barba, VR, Ibarra, CR, Vivas, FR, Nunez, FR, Soriano, JR, Rotes, AS, Salguero, FJS, Capunay, JFS, Peracaula, CS, Andres, AS, Calderon, AS, Vaquerizo, CS, Pascual, ES, Robles, MIS, Sanchez-Manjavacas, AS, Baladron, AS, Garcia, RS, Belmonte, DS, Garcia, MS, Cabrera, PS, Moreno, ATM, Moreno, RTM, Hernandez, MAT, Rico, MT, Prat, SU, Carrasco, AIU, Padrino, EV, Adan, MTV, Albert, SV, Nogales, JV, Walter, CC, Martin, MY, Casajona, MDZ, SECPCC
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p8033
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones8033
Access Level:acceso abierto
Palabra clave:Kawasaki disease
Mucocutaneous lymphnode syndrome
Vasculitis
Arteritis
Coronary aneurysm
Coronary vessels
Aneurysm
Immunoglobulins
intravenous
Steroids
Consensus
Descripción
Sumario:Kawasaki disease is a self-limiting acute vasculitis that affects small and medium-sized vessels, and is the most common cause of acquired heart disease in children in our environment. Up to 25% of untreated patients develop coronary aneurysms. It is suspected that an infectious agent may be the trigger of the disease, but the causative agent is still unknown. Based on the previous evidence, recommendations are proposed for the diagnosis, treatment of acute disease, and the long-term management of these patients, in order to unify criteria. The diagnosis must be quick, based on easy-to-use algorithms and with the support of complementary tests. This document includes the indication of available imaging techniques, as well as the planning of cardiological examinations based on the initial involvement. Intravenous immunoglobulin is the basis of the initial treatment. The role of corticosteroids is still controversial, but there are studies that support its use as adjuvant treatment. A multidisciplinary working group has developed a scheme with different treatment guidelines depending on the risk factors at diagnosis, the patient's clinical situation, and response to previous treatment, including indications for thromboprophylaxis in patients with coronary involvement. The stratification of risk for long-term treatment is essential, as well as the recommendations on the procedures based on the initial cardiological involvement and its progression. Patients with coronary aneurysms require continuous and uninterrupted cardiological monitoring for life. (C) 2018 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.

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