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Kawasakis sykdom

Sist revidert:
Sist revidert av:


Definisjon:
Akutt, febril, selvbegrensende systemisk vaskulitt av ukjent årsak som oftest rammer barn under 5 år. 
Forekomst:
I Sverige har man funnet en insidens på 2,9 per 100.000 barn under 16 år og 6,2 per 100.000 under fem år
Symptomer:
Feber av minst fem dagers varighet + fire av følgende fem funn:
Funn:
Konjunktivitt, makulopapuløst utslett, ensidig forstørrede cervicale lymfeknuter, slimhinneforandringer på lepper og i munnhule, rubor og ødem i hender og fotsåler
Diagnostikk:
Lab.prøver er ikke diagnostiske, men ofte foreligger leukocytose, forhøyet SR og CRP og trombocytose
Behandling:
I sykehus. Intravenøst immunglobulin kombinert med acetylsalisylsyre
  1. 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: e927. pmid:28356445 PubMed  
  2. Rypdal V, Songstad NT, Nyrnes SA, et al. Kawasakis sykdom. Akuttveileder i pediatri. Sist revidert 2021. www.helsebiblioteket.no  
  3. Saguil A, Fargo M, Grogan S.Diagnosis and management of Kawasaki disease. Am Fam Physician 2015 Mar 15;91(6):365-371.
  4. Roed C, Skinhøj P. Kawasakis syndrom hos voksne. Ugeskr Læger 2009; 171: 430. Ugeskrift for Læger  
  5. Brogan P, Burns JC, Cornish J, et al. Lifetime cardiovascular management of patients with previous Kawasaki disease. Heart 2019. pmid:31843876 PubMed  
  6. Harnden A,Tulloh R, Burgner D. Kawasaki disease. BMJ. 2014 Sep 17;349:g5336. doi: 10.1136/bmj.g5336 DOI  
  7. Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020. doi:10.1016/ S0140-6736(20)31103-X
  8. Yellen ES, Gauvreau K, Takahasi M, et. al. Performance of 2004 American Heart Association Recommendations for Treatment of Kawasaki Disease. Pediatrics 2010; 125: 234-41. Pediatrics  
  9. Chen S et al. Coronary Artery Complication in Kawasaki Disease and the Importance of Early Intervention: A Systematic Review and Meta-analysis. JAMA Pediatr 2016; 170: 1156-63. PubMed  
  10. Hamada H, Suzuki H, Onouchi Y, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial. Lancet 2019. pmid:30853151 PubMed  
  11. Ferrara G et al. Anakinra for Treatment-Resistant Kawasaki Disease: Evidence from a Literature Review. Paediatr Drugs 2020; 22: 645-52. PubMed  
  12. Platt B, Belarski E, Manaloor J, et al. Comparison of Risk of Recrudescent Fever in Children With Kawasaki Disease Treated With Intravenous Immunoglobulin and Low-Dose vs High-Dose Aspirin. JAMA Netw Open 2020; 3: e1918565. pmid:31899532 PubMed  
  13. Kobayashi T, Saji T, Otani T, et al. Efficacy of immunoglobulin plus prednisolone for prevention of coronary artery abnormalities in severe Kawasaki disease (RAISE study): a randomised, open-label, blinded-endpoints trial. Lancet 2012; doi:10.1016/S0140-6736(11)61930-2. DOI  
  14. Chen S, Dong Y, Yin Y, Krucoff MW. Intravenous immunoglobulin plus corticosteroid to prevent coronary artery abnormalities in Kawasaki disease: a meta-analysis. Heart 2012. pmid:22869678 PubMed  
  15. Wardle AJ, Connolly GM, Seager MJ, et al. Corticosteroids for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev. 2017 Jan 27;1:CD011188. PMID: 28129459 PubMed  
  16. Tremoulet AH, Jain S, Jaggi P, et al. Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double blind, placebo-controlled trial. Lancet 2014. doi:10.1016/S0140-6736(13)62298-9 DOI  
  17. Zhao QM, Chu C, Wu L, et al. Systemic Artery Aneurysms and Kawasaki Disease. Pediatrics 2019. pmid:31732547 PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Barne- og ungdomsklinikken, St. Olavs Hospital, Trondheim
  • Bengt Granström, överläkare, Barn-och ungdomsmedicinska kliniken, Skånes universitetssjukhus (Medibas)