European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease - the SHARE initiative
Language English Country England, Great Britain Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
21411
Versus Arthritis - United Kingdom
PubMed
30535127
DOI
10.1093/rheumatology/key344
PII: 5233868
Knihovny.cz E-resources
- Keywords
- Kawasaki disease, SHARE recommendations, childhood/paediatric, systemic vasculitis, treatment,
- MeSH
- Child MeSH
- Mucocutaneous Lymph Node Syndrome * MeSH
- Consensus MeSH
- Humans MeSH
- Evidence-Based Medicine standards MeSH
- Pediatrics standards MeSH
- Rheumatology standards MeSH
- Practice Guidelines as Topic standards MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
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.
1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic
Department of Paediatric Rheumatology Alder Hey Children's NHS Foundation Trust Liverpool UK
Department of Paediatric Rheumatology Bicêtre Hospital APHP University of Paris SUD Paris France
Department of Paediatric Rheumatology Gaslini Children's Hospital Genoa Italy
Department of Paediatric Rheumatology Great Ormond Street Hospital for Children London UK
Department of Paediatric Rheumatology Hacettepe University Ankara Turkey
Department of Paediatric Rheumatology University Children's Hospital Ljubljana Ljubljana Slovenia
Department of Paediatric Rheumatology Wilhelmina Children's Hospital Utrecht The Netherlands
Institute of Translational Medicine University of Liverpool Liverpool UK
Meir Medical Centre Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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