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An Pediatr (Barc). 2018 Sep;89(3):188.e1-188.e22. doi: 10.1016/j.anpedi.2018.04.003. Epub 2018 May 16.

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

[Article in Spanish]

Author information

1
Cardiología infantil, Servicio de Pediatría, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas. Electronic address: ana.barrios@salud.madrid.org.
2
Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas; Cardiología infantil, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España.
3
Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas; Cardiología infantil, Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
4
Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Materno Infantil Doce de Octubre, Madrid, España; Sociedad Española de Infectología Pediátrica.
5
Unidad de Reumatología Pediátrica, Servicio de Pediatría, Hospital Parc Taulí, Sabadell, Barcelona, España; Sociedad Española de Reumatología Pediátrica.
6
Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas; Cardiología infantil, Servicio de Pediatría, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.

Abstract

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.

KEYWORDS:

Aneurisma; Aneurisma coronario; Aneurysm; Arterias coronarias; Arteritis; Consenso; Consensus; Coronary aneurysm; Coronary vessels; Corticoides; Enfermedad de Kawasaki; Immunoglobulins; Inmunoglobulina intravenosa; Kawasaki disease; Mucocutaneous lymph node syndrome; Steroids; Síndrome linfomucocutáneo; Vasculitis; intravenous

PMID:
29778491
DOI:
10.1016/j.anpedi.2018.04.003
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