Nienke de Graeff1, Noortje Groot1,2,3, Seza Ozen4, Despina Eleftheriou5, Tadej Avcin6, Brigitte Bader-Meunier7, Pavla Dolezalova8, Brian M Feldman9, Isabelle Kone-Paut10, Pekka Lahdenne11, Liza McCann3, Clarissa Pilkington5, Angelo Ravelli12, Annet van Royen-Kerkhof1, Yosef Uziel13, Bas Vastert1, Nico Wulffraat1, Sylvia Kamphuis2, Paul Brogan5, Michael W Beresford3,14. 1. Department of Paediatric Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands. 2. Department of Paediatric Rheumatology, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands. 3. Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK. 4. Department of Paediatric Rheumatology, Hacettepe University, Ankara, Turkey. 5. Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children, London, UK. 6. Department of Paediatric Rheumatology, University Children's Hospital Ljubljana, Ljubljana, Slovenia. 7. Department of Paediatric Rheumatology, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. 8. First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. 9. Department of Paediatric Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Canada. 10. Department of Paediatric Rheumatology, Bicêtre Hospital, APHP, University of Paris SUD, Paris, France. 11. Department of Paediatric Rheumatology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. 12. Department of Paediatric Rheumatology, Gaslini Children's Hospital, Genoa, Italy. 13. Meir Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 14. Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Abstract
OBJECTIVES: The European Single Hub and Access point for paediatric Rheumatology in Europe initiative aimed to optimize care for children with rheumatic diseases. Kawasaki disease (KD) is the most common cause of acquired heart disease in children and an important cause of long-term cardiac disease into adulthood. Prompt diagnosis and treatment of KD is difficult due to the heterogeneity of the disease but is crucial for improving outcome. To date, there are no European internationally agreed, evidence-based guidelines concerning the diagnosis and treatment of KD in children. Accordingly, treatment regimens differ widely. The aim of this study is to provide consensus-based, European-wide evidence-informed recommendations for diagnosis and treatment of children with KD. METHODS: Recommendations were developed using the EULAR's standard operating procedures. An extensive systematic literature search was performed, and evidence-based recommendations were extrapolated from the included papers. These were evaluated by a panel of international experts via online surveys and subsequently discussed in three consensus meetings, using nominal group technique. Recommendations were accepted when ⩾80% agreed. RESULTS: In total, 17 recommendations for diagnosis and 14 for treatment of KD in children were accepted. Diagnostic recommendations included laboratory and imaging workup for complete as well as incomplete KD. Treatment recommendations included the importance of early treatment in both complete and incomplete KD, use of intravenous immunoglobulin, aspirin, corticosteroids for high-risk cases, and other treatment options for those with resistant disease. CONCLUSION: The Single Hub and Access point for paediatric Rheumatology in Europe initiative provides international evidence-based recommendations for diagnosing and treating KD in children, facilitating improvement and uniformity of care.
OBJECTIVES: The European Single Hub and Access point for paediatric Rheumatology in Europe initiative aimed to optimize care for children with rheumatic diseases. Kawasaki disease (KD) is the most common cause of acquired heart disease in children and an important cause of long-term cardiac disease into adulthood. Prompt diagnosis and treatment of KD is difficult due to the heterogeneity of the disease but is crucial for improving outcome. To date, there are no European internationally agreed, evidence-based guidelines concerning the diagnosis and treatment of KD in children. Accordingly, treatment regimens differ widely. The aim of this study is to provide consensus-based, European-wide evidence-informed recommendations for diagnosis and treatment of children with KD. METHODS: Recommendations were developed using the EULAR's standard operating procedures. An extensive systematic literature search was performed, and evidence-based recommendations were extrapolated from the included papers. These were evaluated by a panel of international experts via online surveys and subsequently discussed in three consensus meetings, using nominal group technique. Recommendations were accepted when ⩾80% agreed. RESULTS: In total, 17 recommendations for diagnosis and 14 for treatment of KD in children were accepted. Diagnostic recommendations included laboratory and imaging workup for complete as well as incomplete KD. Treatment recommendations included the importance of early treatment in both complete and incomplete KD, use of intravenous immunoglobulin, aspirin, corticosteroids for high-risk cases, and other treatment options for those with resistant disease. CONCLUSION: The Single Hub and Access point for paediatric Rheumatology in Europe initiative provides international evidence-based recommendations for diagnosing and treating KD in children, facilitating improvement and uniformity of care.
Authors: Victoria C Ziesenitz; Tatjana Welzel; Madelé van Dyk; Patrick Saur; Matthias Gorenflo; Johannes N van den Anker Journal: Paediatr Drugs Date: 2022-09-02 Impact factor: 3.930
Authors: Hany Simon Junior; Tania Miyuki Shimoda Sakano; Regina Maria Rodrigues; Adriana Pasmanik Eisencraft; Vitor Emanoel Lemos de Carvalho; Claudio Schvartsman; Amelia Gorete Afonso da Costa Reis Journal: J Pediatr (Rio J) Date: 2020-09-11 Impact factor: 2.990