TY - JOUR
T1 - European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease - the SHARE initiative
AU - de Graeff, Nienke
AU - Groot, Noortje
AU - Ozen, Seza
AU - Eleftheriou, Despina
AU - Avcin, Tadej
AU - Bader-Meunier, Brigitte
AU - Dolezalova, Pavla
AU - Feldman, Brian M
AU - Kone-Paut, Isabelle
AU - Lahdenne, Pekka
AU - McCann, Liza
AU - Pilkington, Clarissa
AU - Ravelli, Angelo
AU - van Royen-Kerkhof, Annet
AU - Uziel, Yosef
AU - Vastert, Bas
AU - Wulffraat, Nico
AU - Kamphuis, Sylvia
AU - Brogan, Paul
AU - Beresford, Michael W
N1 - © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].
PY - 2019/4
Y1 - 2019/4
N2 - 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.
AB - 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.
KW - Childhood/paediatric
KW - Kawasaki disease
KW - SHARE recommendations
KW - systemic vasculitis
KW - treatment
KW - childhood
KW - paediatric
UR - http://www.scopus.com/inward/record.url?scp=85063712194&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/key344
DO - 10.1093/rheumatology/key344
M3 - Article
C2 - 30535127
SN - 1462-0324
VL - 58
SP - 672
EP - 682
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 4
ER -