To access this material please log in or register

Register Authorize

Complications and remote consequences of Kawasaki disease

Klemenov A. V.1, Vostokova A. A.2
1 - State Budgetary Institution of Health Care of Nizhegorodskaya Region, "Municipal Clinical Hospital #30", Berezovskaya 85a, Nizhnyi Novgorod 603157
2 - State Budgetary Institution of Health Care of Nizhegorodskaya Region, "Municipal Clinical Hospital #5", Nesterova 34, Nizhnyi Novgorod 603005

Keywords: Kawasaki disease, coronary arteries, prognosis

DOI: 10.18087/rhj.2015.2.2040

Kawasaki disease (KD) is acute systemic vasculitis which develops almost exclusively in children younger than 4–5 years. The most serious manifestation of KD is damage to coronary arteries associated with both organic (aneurysm) and functional (endothelial dysfunction) disorders. Subsequently these disorders predispose patients to stenosis and thrombotic occlusion with a high probability. At present, cardiologists in increasing frequency see adult patients with remote consequences of KD which the patients had in their childhood. The review presents information about possible complications and remote consequences of KD, which may affect health of patients in their adult life.
  1. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the toes and fingers in children. Arerugi. 1967 Mar;16 (3):178–222.
  2. Burns JC. Finding Kawasaki disease. Ann Pediatr Cardiol. 2012 Jul;5 (2):133–4.
  3. 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 Oct 26;110 (17):2747–71.
  4. Suzuki A, Miyagawa-Tomita S, Komatsu K et al. Active remode­ling of the coronary arterial lesions in the late phase of Kawasaki disease: immunohistochemical study. Circulation. 2000 Jun 27;101 (25):2935–41.
  5. JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2008) – digest version. Circ J. 2010 Sep;74 (9):1989–2020.
  6. Yanagawa H, Nakamura Y, Yashiro M et al. Incidence survey of Kawasaki disease in 1997 and 1998 in Japan. Pediatrics. 2001 Mar;107 (3):E33.
  7. Gordon JB, Kahn AM, Burns JC. When children with Kawasaki disease grow up myocardial and vascular complications in adulthood. J Am Coll Cardiol. 2009 Nov 17;54 (21):1911–20.
  8. Sakata K, Hamaoka K, Ozawa S et al. Matrix metalloproteinase-9 in vascular lesions and endothelial regulation in Kawasaki disease. Circ J. 2010 Aug;74 (8):1670–5.
  9. Shirai N, Yabana T, Ueda M. Pathology of Kawasaki disease. Nihon Rinsho. 2008 Feb;66 (2):251–7.
  10. Brown TJ, Crawford SE, Cornwall ML et al. CD8 T lymphocytes and macrophages infiltrate coronary artery aneurysms in acute Kawasaki disease. J Infect Dis. 2001 Oct 1;184 (7):940–3.
  11. Azmoon S, Atkinson D, Budoff MJ. Refractory progression of co­ronary aneurysms, a case of delayed onset Kawasaki disease as depicted by cardiac computed tomography angiography. Congenit Heart Dis. 2010 May-Jun;5 (3):321–6.
  12. Burns JC, Shike H, Gordon JB et al. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol. 1996 Jul;28 (1):253–7.
  13. Chang FY, Hwang B, Chen SJ et al. Characteristics of Kawasaki disease in infants younger than six months of age. Pediatr Infect Dis J. 2006 Mar;25 (3):241–4.
  14. Newburger JW, Takahashi M, Beiser AS et al. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med. 1991 Jun 6;324 (23):1633–9.
  15. Bajolle F, Laux D. Kawasaki disease: what you need to know. Arch Pediatr. 2012 Nov;19 (11):1264–8.
  16. 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 Jul 10;116 (2):174–9.
  17. Berdej-Szczot E, Firek-Pędras M, Szydłowski L et al. Analysis of risk factors and prospective evaluation of cardiovascular complications of Kawasaki disease in children: a single centre study. Kardiol Pol. 2013;71 (12):1279–86.
  18. Bal AK, Prasad D, Umali Pamintuan MA et al. Timing of intravenous immunoglobulin treatment and risk of coronary artery abnormalities in children with Kawasaki disease. Pediatr Neonatol. 2014 Oct;55 (5):387–92.
  19. Kitano N, Suzuki H, Takeuchi T et al. Epidemiologic features and prognostic factors of coronary artery lesions associated with Kawasaki disease based on a 13‑year cohort of consecutive cases identified by complete enumeration surveys in Wakayama, Japan. J Epidemiol. 2014;24 (5):427–34.
  20. Moran AM, Newburger JW, Sanders SP et al. Abnormal myocardial mechanics in Kawasaki disease: rapid response to gamma-globulin. Am Heart J. 2000 Feb;139 (2 Pt 1):217–23.
  21. Senzaki H. Long-term outcome of Kawasaki disease. Circulation. 2008 Dec 16;118 (25):2763–72.
  22. Miyamoto T, Ikeda K, Ishii Y, Kobayashi T. Rupture of a coronary artery aneurysm in Kawasaki disease: a rare case and review of the literature for the past 15 years. J Thorac Cardiovasc Surg. 2014 Jun;147 (6):67–9.
  23. Hartopo AB, Setianto BY. Coronary artery sequel of Kawasaki disease in adulthood, a concern for internists and cardiologists. Acta Med Indones. 2013 Jan;45 (1):69–75.
  24. Nakamura Y, Yashiro M, Uehara R et al. Epidemiologic features of Kawasaki disease in Japan: results from the nationwide survey in 2005–2006. J Epidemiol. 2008;18 (4):167–72.
  25. Falcini F. Kawasaki disease. Curr Opin Rheumatol. 2006 Jan;18 (1):33–8.
  26. Samada K, Shiraishi H, Sato A, Momoi MY. Grown-up Kawasaki disease patients who have giant coronary aneurysms. World J Pediatr. 2010 Feb;6 (1):38–42.
  27. Kuramochi Y, Ohkubo T, Takechi N et al. Hemodynamic factors of thrombus formation in coronary aneurysms associated with Kawasaki disease. Pediatr Int. 2000 Oct;42 (5):470–5.
  28. Suzuki A, Miyagawa-Tomita S, Nakazawa M, Yutani C. Remodeling of coronary artery lesions due to Kawasaki disease: comparison of arteriographic and immunohistochemical findings. Jpn Heart J. 2000 May;41 (3):245–56.
  29. Bayers S, Shulman ST, Paller AS. Kawasaki disease: part II. Compli­cations and treatment. J Am Acad Dermatol. 2013 Oct;69 (4):521–2.
  30. Tsuda E, Kamiya T, Ono Y et al. Dilated coronary arterial lesions in the late period after Kawasaki disease. Heart. 2005 Feb;91 (2):177–82.
  31. Muneuchi J, Joo K, Morihana E, Mizushima A. Detectable silent calcification in a regressed coronary artery aneurysm of a young adult with a history of Kawasaki disease. Pediatr Cardiol. 2008 Jan;29 (1):195–7.
  32. Kato H, Sugimura T, Akaqi T et al. Long-term consequences of Kawasaki disease. A 10- to 21‑year follow-up study of 594 patients. Circulation. 1996 Sep 15;94 (6):1379–85.
  33. Iemura M, Ishii M, Sugimura T et al. Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart. 2000 Mar;83 (3):307–11.
  34. Mitani Y, Ohashi H, Sawada H et al. In vivo plaque composition and morphology in coronary artery lesions in adolescents and young adults long after Kawasaki disease: a virtual histology-intravascular ultrasound study. Circulation. 2009 Jun 2;119 (21):2829–36.
  35. Rozo JC, Jefferies JL, Eidem BW, Cook PJ. Kawasaki disease in the adult. A case report and review of the literature. Tex Heart Inst J. 2004;31 (2):160–4.
  36. Terashima M, Awano K, Honda Y et al. Images in cardiovascular medicine. «Arteries within the artery» after Kawasaki disease: a lotus root appearance by intravascular ultrasound. Circulation. 2002 Aug 13;106 (7):887.
  37. Ishii M, Ueno T, Ikeda H et al. Sequential follow-up results of cathe­ter intervention for coronary artery lesions after Kawasaki disease: quantitative coronary artery angiography and intravascular ultrasound imaging study. Circulation. 2002 Jun 25;105 (25):3004–10.
  38. Ozawa J, Suzuki H, Hasegawa S et al. Two cases of new coronary aneurysms that developed in the late period after Kawasaki disease. Pediatr Cardiol. 2013;34 (8):1992–5.
  39. Tsuda E, Arakaki Y, Shimizu T et al. Changes in causes of sudden deaths in patients with coronary arterial lesions due to Kawasaki disease. Cardiol Young. 2005 Oct;15 (5):481–8.
  40. Kaichi S, Tsuda E, Fujita H et al. Acute coronary artery dilation due to Kawasaki disease and subsequent late calcification as detected by electron beam computed tomography. Pediatr Cardiol. 2008 May;29 (3):568–73.
  41. Lin J, Jain S, Sun X et al. Lipoprotein particle concentrations in children and adults following Kawasaki disease. J Pediatr. 2014 Oct;165 (4):727–31.
  42. Tsuda E, Abe T, Tamaki W. Acute coronary syndrome in adult patients with coronary artery lesions caused by Kawasaki disease: review of case reports. Cardiol Young. 2011 Feb;21 (1):74–82.
  43. Takahashi K, Oharaseki T, Naoe S. Pathological study of postcoronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and athe­rosclerosis. Pediatr Cardiol. 2001Mar-Apr;22 (2):138–42.
  44. Gillebert C, Vandeyk K, Troost E et al. Mid-term outcome of patients with Kawasaki disease, single-centre experience. Acta Cardiol. 2010 Jun;65 (3):291–5.
  45. Okura N, Okuda T, Shiotani S et al. Sudden death as a late sequel of Kawasaki disease: postmortem CT demonstration of coronary artery aneurysm. Forensic Sci Int. 2013 Feb 10;225 (1–3):85–8.
  46. Tsuda E, Hamaoka K, Suzuki H et al. A survey of the 3‑decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J. 2014 Feb;167 (2):249–58.
  47. Noto N, Kamiyama H, Karasawa K et al. Long-term prognostic impact of dobutamine stress echocardiography in patients with Kawasaki disease and coronary artery lesions: a 15‑year follow-up study. J Am Coll Cardiol. 2014 Feb 4;63 (4):337–44.
  48. Kim JW, Goo HW. Coronary artery abnormalities in Kawasaki disease: comparison between CT and MR coronary angiography. Acta Radiol. 2013 Mar 1;54 (2):156–63.
  49. Jin B, Feng XY. Dual-source CT imaging of multiple giant coronary and axillary aneurysms in a child with Kawasaki disease. Eur Rev Med Pharmacol Sci. 2014;18 (14):1969–72.
  50. Kawai H, Takakuwa Y, Naruse H et al. Two cases with past Kawasaki disease developing acute myocardial infarction in their thirties, despite being regarded as at low risk for coronary events. Heart Vessels. 2014 Jul 2. [Epub ahead of print].
  51. McCrindle BW. Kawasaki disease: a childhood disease with important consequences into adulthood. Circulation. 2009 Jul 7;120 (1):6–8.
  52. Hauser M, Bengel F, Kuehn A et al. Myocardial blood flow and co­ro­nary flow reserve in children with «normal» epicardial coronary arteries after the onset of Kawasaki disease assessed by positron emission tomography. Pediatr Cardiol. 2004 Mar-Apr;25 (2):108–12.
  53. Ishikawa T, Iwashima S. Endothelial dysfunction in children within 5 years after onset of Kawasaki disease. J Pediatr. 2013 Oct;163 (4):1117–21.
  54. Selamet Tierney ES, Gal D, Gauvreau K et al. Vascular health in Kawasaki disease. J Am Coll Cardiol. 2013 Sep 17;62 (12):1114–21.
  55. Pinto FF, Laranjo S, Paramés F et al. Long-term evaluation of endothelial function in Kawasaki disease patients. Cardiol Young. 2013 Aug;23 (4):517–22.
  56. Meena RS, Rohit M, Gupta A, Singh S. Carotid intima-media thickness in children with Kawasaki disease. Rheumatol Int. 2014 Aug;34 (8):1117–21.
  57. Negoro N, Nariyama J, Nakagawa A et al. Successful catheter interventional therapy for acute coronary syndrome secondary to Kawasaki disease in young adults. Circ J. 2003 Apr;67 (4):362–5.
  58. Tobayama H, Takahashi K, Fukunaga H et al. Analysis of arterial function in adults with a history of Kawasaki disease. J Cardiol. 2013 May;61 (5):330–5.
  59. Manlhiot C, Niedra E, McCrindle BW. Long-term management of Kawasaki disease: implications for the adult patient. Pediatr Neonatol. 2013 Feb;54 (1):12–21.
  60. Laurito M, Stazi A, Delogu AB et al. Endothelial and platelet function in children with previous Kawasaki disease. Angiology. 2014 Sep;65 (8):716–22.
  61. Akagi T, Kato H, Inoue O et al. Valvular heart disease in Kawasaki syndrome: incidence and natural history. Am Heart J. 1990 Aug;120 (2):366–72.
  62. Ravekes WJ, Colan SD, Gauvreau K et al. Aortic root dilation in Kawasaki disease. Am J Cardiol. 2001 Apr 1;87 (7):919–22.
  63. Tacke CE, Romeih S, Kuipers IM et al. Evaluation of cardiac function by magnetic resonance imaging during the follow-up of patients with Kawasaki disease. Circ Cardiovasc Imaging. 2013 Jan 1;6 (1):67–73.
  64. Kurotobi S, Kawakami N, Shimizu K et al. Brain natriuretic peptide as a hormonal marker of ventricular diastolic dysfunction in children with Kawasaki disease. Pediatr Cardiol. 2005 Jul-Aug;26 4):425–30.
  65. Takeuchi D, Saji T, Takatsuki S, Fujiwara M. Abnormal tissue doppler images are associated with elevated plasma brain natriuretic peptide and increased oxidative stress in acute Kawasaki disease. Circ J. 2007 Mar;71 (3):357–62.
  66. Tsuda E, Matsuo M, Naito H et al. Clinical features in adults with coronary arterial lesions caused by presumed Kawasaki disease. Cardiol Young. 2007 Feb;17 (1):84–9.
  67. Yagi S, Tsuda E, Shimizu W et al. Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease. Circ J. 2005 Jul;69 (7):870–4.
  68. Ishida A, Matsuo S, Kawamura S, Nishikawa T. Subarachnoid hemor­rhage due to nonbranching aneurysm of the middle cerebral artery in a young adult with a history of Kawasaki disease. Surg Neurol Int. 2014 Jan;5:5.
  69. Sabatier I, Chabrier S, Brun A et al. Stroke by carotid artery complete occlusion in Kawasaki disease: case report and review of litera­ture. Pediatr Neurol. 2013 Dec;49 (6):469–73.
  70. Ekici F, Varan B, Kocabaş A et al. Multiple giant aneurysms and stenoses of the coronary and systemic arteries in an infant with Kawasaki disease at the early stage of convalescent period. Echocardiography. 2014 May;31 (5):147–50.
  71. Holman RC, Curns AT, Belay ED et al. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics. 2003 Sep;112 (3 Pt 1):495–501.
  72. Huang SK, Lin MT, Chen HC et al. Epidemiology of Kawasaki disease: prevalence from national database and future trends projection by system dynamics modeling. J Pediatr. 2013 Jul;163 (1):126–31.
  73. Nakamura Y, Yashiro M, Uehara R et al. Epidemiologic features of Kawasaki disease in Japan: results of the 2007–2008 nationwide survey. J Epidemiol. 2010;20 (4):302–7.
  74. Lue HC, Chen LR, Lin MT et al. Epidemiological features of Kawasaki disease in Taiwan, 1976–2007: results of five nationwide questionnaire hospital surveys. Pediatr Neonatol. 2014 Apr;55 (2):92–6.
  75. Hwang B. Epidemiology of Kawasaki disease. Pediatr Neonatol. 2014 Apr;55 (2):78.
  76. Saundankar J, Yim D, Itotoh B et al. The epidemiology and clinical features of Kawasaki disease in Australia. Pediatrics. 2014 Apr;133 (4):1009–14.
  77. Callinan LS, Holman RC, Vugia DJ et al. Kawasaki disease hospitalization rate among children younger than 5 years in California, 2003–2010. Pediatr Infect Dis J. 2014 Jul;33 (7):781–3.
  78. Gordon CT, Jimenez-Fernandez S, Daniels LB et al. Pregnancy in women with a history of Kawasaki disease: management and outcomes. BJOG. 2014 Oct;121 (11):1431–8.
  79. Youssef A, Ben Amara F, M'barki M et al. Successful pregnancy and delivery in patient with artery bypass grafting for coronary lesion caused by Kawasaki disease. Tunis Med. 2013 Mar;91 (3):217–8.
  80. Tsuda E, Ishihara Y, Kawamata K et al. Pregnancy and delivery in patient with coronary artery caused by Kawasaki disease. Heart. 2005 Nov;91 (11):1481–2.
Klemenov A. V., Vostokova A. A. Complications and remote consequences of Kawasaki disease. Russian Heart Journal. 2015;14 (2):98–103

To access this material please log in or register

Register Authorize
Ru En