The Experts below are selected from a list of 243 Experts worldwide ranked by ideXlab platform
Lawrence B. Schonberger - One of the best experts on this subject based on the ideXlab platform.
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Abstract O.03: Monitoring the Occurrence of Kawasaki Syndrome in the United States
Circulation, 2015Co-Authors: Ryan A. Maddox, Lawrence B. Schonberger, Marissa K. Person, Lindsay J Joseph, Dana L. Haberling, Claudia A Steiner, Ermias D. BelayAbstract:Objectives: To describe the occurrence of Kawasaki Syndrome (KS) in the United States. Methods: The Kids’ Inpatient Database (KID; 2003, 2006, 2009, 2012) and the Nationwide Inpatient Sample (NIS; ...
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evaluation of clinical characteristics of Kawasaki Syndrome and risk factors for coronary artery abnormalities among children in denmark
Acta Paediatrica, 2013Co-Authors: Amy Patel, Robert C. Holman, Lawrence B. Schonberger, Laura S Callinan, Nandini Sreenivasan, Thea Kolsen Fischer, Ermias D. BelayAbstract:Aim To examine clinical characteristics, treatment and outcome of Kawasaki Syndrome patients in Denmark. Methods A retrospective chart review of hospitalization records for children <15 years of age with a Kawasaki Syndrome discharge diagnosis identified through the Danish National Patient Registry during 1994 through June 2008 was conducted. Results A total of 284 cases <15 years of age were identified as Kawasaki Syndrome (n = 279) and atypical Kawasaki Syndrome (n = 5); 70.4% were <5 years of age and 64.4% were male. Most patients (91.5%; 258/282) were treated with intravenous immunoglobulin and 74.6% of these patients (191/256) received intravenous immunoglobulin before the 10th day of illness. A total of 37 (13.3%) Kawasaki Syndrome patients were diagnosed with coronary artery abnormalities. Not receiving intravenous immunoglobulin treatment before the 10th day of illness, young age and male sex were significantly associated with the development of coronary artery abnormalities. Conclusions In Denmark, more than one in 10 children with Kawasaki Syndrome develop coronary artery abnormalities. Physicians should increase their index of suspicion for early diagnosis and treatment of Kawasaki Syndrome among patients susceptible to increased risk of coronary artery abnormalities, particularly in infants who may have a more atypical presentation of the illness.
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Evaluation of clinical characteristics of Kawasaki Syndrome and risk factors for coronary artery abnormalities among children in Denmark.
Acta paediatrica (Oslo Norway : 1992), 2013Co-Authors: Amy Patel, Robert C. Holman, Lawrence B. Schonberger, Laura S Callinan, Nandini Sreenivasan, Thea Kolsen Fischer, Ermias D. BelayAbstract:Aim To examine clinical characteristics, treatment and outcome of Kawasaki Syndrome patients in Denmark. Methods A retrospective chart review of hospitalization records for children
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Kawasaki Syndrome hospitalizations in ireland 1996 through 2000
Pediatric Infectious Disease Journal, 2003Co-Authors: Maureen Lynch, Robert C. Holman, Ermias D. Belay, Aisling Mulligan, Lawrence B. SchonbergerAbstract:Objective.To describe the epidemiologic characteristics and estimate the incidence of Kawasaki Syndrome (KS) among children in Ireland.Methods.Hospital discharge records with a KS diagnosis among patients <18 years of age were examined using Ireland’s Hospital In-Patient Enquiry database for 1996 th
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Kawasaki Syndrome hospitalizations in the united states 1997 and 2000
Pediatrics, 2003Co-Authors: Robert C. Holman, Ermias D. Belay, Claudia A Steiner, Aaron T Curns, Lawrence B. SchonbergerAbstract:Objective. To estimate the incidence and describe the epidemiologic characteristics of Kawasaki Syndrome (KS) among children in the United States. Methods. Hospital discharge records with a KS diagnosis among patients Results. In 2000, ∼4248 hospitalizations associated with KS occurred in the United States, and the median age of patients at admission was 2 years. Children Conclusions. Among children
Donald Y.m. Leung - One of the best experts on this subject based on the ideXlab platform.
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Kawasaki Syndrome role of superantigens revisited
FEBS Journal, 2021Co-Authors: Donald Y.m. Leung, Patrick M. SchlievertAbstract:Kawasaki Syndrome (KS) is an acute vasculitis in children complicated by the development of heart disease. Despite its description over 50 years ago, the etiology of coronary artery disease in KS is unknown. High dose intravenous immunoglobulin is the most effective approach to reduce cardiovascular complications. It remains unclear why patients with KS develop coronary artery aneurysms. A subset of patients is resistant to immunoglobulin therapy. Given the heterogeneity of clinical features, variability of history, and therapeutic response, KS may be a cluster of phenotypes triggered by multiple infectious agents and influenced by various environmental, genetic, and immunologic responses. The cause of KS is unknown, and a diagnostic test remains lacking. A better understanding of mechanisms leading to acute KS would contribute to a more precision medicine approach for this complex disease. In the current viewpoint, we make the case for microbial superantigens as important causes of KS.
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Kawasaki Syndrome: where are the answers?
PEDIATRICS, 2003Co-Authors: H. Cody Meissner, Donald Y.m. LeungAbstract:Thirty-six years ago, Tomisaku Kawasaki penned the first description of a quixotic illness that he called mucocutaneous lymph node Syndrome.1 Today this illness has been described in almost every country of the world. In studies from North America, Japan, and Western Europe, Kawasaki Syndrome has replaced rheumatic fever as the most common cause of acquired heart disease.2 Despite the importance of Kawasaki Syndrome as a cause of disease in children, a surprising number of aspects of this Syndrome remain ill-defined. Because the etiology remains incompletely understood, the diagnosis is based on history and physical examination. Because the symptoms of Kawasaki Syndrome are not unique and diagnosis can be difficult, it is likely that many cases of incomplete or atypical Kawasaki Syndrome, as well as some presentations of classic Kawasaki Syndrome, remain undiagnosed and untreated, and the child remains at risk of undetected coronary artery disease. Therapy with intravenous immunoglobulin (IGIV) and aspirin, while effective, is nonspecific and is associated with the problems of gamma globulin infusions. These problems include the need for intravenous cannulation, risk of adverse reactions, concern for possible adventitious agents, interference with the immune response to live vaccines, expense, shortages, and the fact that 2% to 4%% of treated children still develop coronary artery disease. Furthermore, the long-term cardiac outcome of children who experience Kawasaki Syndrome both for those with and those without detectable coronary artery involvement is not clear. After >3 decades of study, what is known about Kawasaki Syndrome and why are there still so many unanswered questions? The study by Holman et al3 in this issue of Pediatrics supports previous estimates regarding certain epidemiologic aspects of Kawasaki Syndrome and offers important new detail into others. Using hospital discharge data from the Kids’ Inpatient Database (22 participating states), the authors address a … Address correspondence to H. Cody Meissner, MD, Pediatric Infectious Diseases Division, Tufts-New England Medical Center, 750 Washington St, Boston, MA 02111. E-mail: cmeissner{at}tufts-nemc.org
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The potential role of bacterial superantigens in the pathogenesis of Kawasaki Syndrome
Journal of Clinical Immunology, 1995Co-Authors: Donald Y.m. Leung, Cody Meissner, David Fulton, Patrick M. SchlievertAbstract:Kawasaki Syndrome is an acute multisystem vasculitis of infancy and early childhood associated with high fever, mucocutaneous inflammation, and the development of coronary artery abnormalities. Despite the widely held belief that Kawasaki Syndrome is an infectious disease, investigations have failed to identify a causal organism. Previous studies have demonstrated that this illness is associated with marked activation of monocyte/macrophages and the selective expansion of V β 2- and, less so, of V β 8.1/8.2-expressing T cells in the peripheral blood from Kawasaki Syndrome patients during the acute phase of their illness. These immunologic features are characteristic of diseases that are caused by bacterial toxins which act as superantigens. Staphylococcal enterotoxins and streptococcal exotoxins are prototypic superantigens which stimulate large populations of T cells expressing particular T-cell receptor β -chain variable (Vβ) gene segments. Using the V β 2^+ T-cell expansion as an “immunologic footprint” for a superantigen, we have extended these observations to the identification and isolation of a novel clone of toxic shock Syndrome toxin-1-producing Staphylococcus aureus in the majority of patients with Kawasaki Syndrome and streptococcal pyrogenic exotoxin B/streptococcal pyrogenic exotoxin C-producing streptococci in a minority of Kawasaki Syndrome patients. Toxic shock Syndrome toxin-1, streptococcal pyrogenic exotoxin B, and streptococcal pyrogenic exotoxin C are known to stimulate V β 2^+ T cells. These observations support the hypothesis that the activation of Vβ2^+ T cells during the acute phase of Kawasaki Syndrome is caused by bacterial superantigen(s).
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Superantigens in Kawasaki Syndrome
Clinical immunology and immunopathology, 1995Co-Authors: Donald Y.m. Leung, H. Cody Meissner, David Fulton, Fred W. Quimby, Patrick M. SchlievertAbstract:Kawasaki Syndrome (KS) is an acute multisystem vasculitis of infancy and early childhood associated with the development of myocarditis and coronary artery abnormalities. Despite the widely held belief that KS is caused by an infectious agent, there remains considerable controversy over its etiology. Recent immunologic and microbiologic studies suggest a potential role for staphylococcal and streptococcal toxins (superantigens) in the pathogenesis of KS. Confirmation of these findings could result in more effective diagnostic and therapeutic approaches to this common cause of acquired heart disease in children.
Patrick M. Schlievert - One of the best experts on this subject based on the ideXlab platform.
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Kawasaki Syndrome role of superantigens revisited
FEBS Journal, 2021Co-Authors: Donald Y.m. Leung, Patrick M. SchlievertAbstract:Kawasaki Syndrome (KS) is an acute vasculitis in children complicated by the development of heart disease. Despite its description over 50 years ago, the etiology of coronary artery disease in KS is unknown. High dose intravenous immunoglobulin is the most effective approach to reduce cardiovascular complications. It remains unclear why patients with KS develop coronary artery aneurysms. A subset of patients is resistant to immunoglobulin therapy. Given the heterogeneity of clinical features, variability of history, and therapeutic response, KS may be a cluster of phenotypes triggered by multiple infectious agents and influenced by various environmental, genetic, and immunologic responses. The cause of KS is unknown, and a diagnostic test remains lacking. A better understanding of mechanisms leading to acute KS would contribute to a more precision medicine approach for this complex disease. In the current viewpoint, we make the case for microbial superantigens as important causes of KS.
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Kawasaki Syndrome-Like Illness Associated with Infection Caused by Enterotoxin B-Secreting Staphylococcus aureus
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1999Co-Authors: Mary Hall, Patrick M. Schlievert, Laura Hoyt, Patricia Ferrieri, Hal B. JensonAbstract:Two children had symptoms and clinical signs that were characteristic of the diagnostic criteria for Kawasaki Syndrome, temporally associated with Staphylococcus aureus bacteremia. One child initially had focal osteomyelitis that was evident clinically and radiographically, and radiographic evidence of multifocal osteomyelitis was noted at follow-up. The blood-borne S. aureus isolates from these two patients secreted staphylococcal enterotoxin B and were negative for toxic shock Syndrome toxin. Staphylococcal and streptococcal superantigens may play a role in the pathogenesis of some cases of Kawasaki Syndrome or Kawasaki Syndrome-like illness.
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The potential role of bacterial superantigens in the pathogenesis of Kawasaki Syndrome
Journal of Clinical Immunology, 1995Co-Authors: Donald Y.m. Leung, Cody Meissner, David Fulton, Patrick M. SchlievertAbstract:Kawasaki Syndrome is an acute multisystem vasculitis of infancy and early childhood associated with high fever, mucocutaneous inflammation, and the development of coronary artery abnormalities. Despite the widely held belief that Kawasaki Syndrome is an infectious disease, investigations have failed to identify a causal organism. Previous studies have demonstrated that this illness is associated with marked activation of monocyte/macrophages and the selective expansion of V β 2- and, less so, of V β 8.1/8.2-expressing T cells in the peripheral blood from Kawasaki Syndrome patients during the acute phase of their illness. These immunologic features are characteristic of diseases that are caused by bacterial toxins which act as superantigens. Staphylococcal enterotoxins and streptococcal exotoxins are prototypic superantigens which stimulate large populations of T cells expressing particular T-cell receptor β -chain variable (Vβ) gene segments. Using the V β 2^+ T-cell expansion as an “immunologic footprint” for a superantigen, we have extended these observations to the identification and isolation of a novel clone of toxic shock Syndrome toxin-1-producing Staphylococcus aureus in the majority of patients with Kawasaki Syndrome and streptococcal pyrogenic exotoxin B/streptococcal pyrogenic exotoxin C-producing streptococci in a minority of Kawasaki Syndrome patients. Toxic shock Syndrome toxin-1, streptococcal pyrogenic exotoxin B, and streptococcal pyrogenic exotoxin C are known to stimulate V β 2^+ T cells. These observations support the hypothesis that the activation of Vβ2^+ T cells during the acute phase of Kawasaki Syndrome is caused by bacterial superantigen(s).
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The potential role of bacterial superantigens in the pathogenesis of Kawasaki Syndrome.
Journal of clinical immunology, 1995Co-Authors: D Y Leung, Cody Meissner, David Fulton, Patrick M. SchlievertAbstract:Kawasaki Syndrome is an acute multisystem vasculitis of infancy and early childhood associated with high fever, mucocutaneous inflammation, and the development of coronary artery abnormalities. Despite the widely held belief that Kawasaki Syndrome is an infectious disease, investigations have failed to identify a causal organism. Previous studies have demonstrated that this illness is associated with marked activation of monocyte/macrophages and the selective expansion of V beta 2-, less so, of V beta 8.1/8.2-expressing T cells in the peripheral blood from Kawasaki Syndrome patients during the acute phase of their illness. These immunologic features are characteristic of diseases that are caused by bacterial toxins which act as superantigens. Staphylococcal enterotoxins and streptococcal exotoxins are prototypic superantigens which stimulate large populations of T cells expressing particular T-cell receptor beta-chain variable (V beta) gene segments. Using the V beta 2+ T-cell expansion as an "immunologic footprint" for a superantigen, we have extended these observations to the identification and isolation of a novel clone of toxic shock Syndrome toxin-1-producing Staphylococcus aureus in the majority of patients with Kawasaki Syndrome and streptococcal pyrogenic exotoxin B/streptococcal pyrogenic exotoxin C-producing streptococci in a minority of Kawasaki Syndrome patients. Toxic shock Syndrome toxin-1, streptococcal pyrogenic exotoxin B, and streptococcal pyrogenic exotoxin C are known to stimulate V beta 2+ T cells. These observations support the hypothesis that the activation of V beta 2+ T cells during the acute phase of Kawasaki Syndrome is caused by bacterial superantigen(s).
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Superantigens in Kawasaki Syndrome
Clinical immunology and immunopathology, 1995Co-Authors: Donald Y.m. Leung, H. Cody Meissner, David Fulton, Fred W. Quimby, Patrick M. SchlievertAbstract:Kawasaki Syndrome (KS) is an acute multisystem vasculitis of infancy and early childhood associated with the development of myocarditis and coronary artery abnormalities. Despite the widely held belief that KS is caused by an infectious agent, there remains considerable controversy over its etiology. Recent immunologic and microbiologic studies suggest a potential role for staphylococcal and streptococcal toxins (superantigens) in the pathogenesis of KS. Confirmation of these findings could result in more effective diagnostic and therapeutic approaches to this common cause of acquired heart disease in children.
Ermias D. Belay - One of the best experts on this subject based on the ideXlab platform.
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Abstract O.03: Monitoring the Occurrence of Kawasaki Syndrome in the United States
Circulation, 2015Co-Authors: Ryan A. Maddox, Lawrence B. Schonberger, Marissa K. Person, Lindsay J Joseph, Dana L. Haberling, Claudia A Steiner, Ermias D. BelayAbstract:Objectives: To describe the occurrence of Kawasaki Syndrome (KS) in the United States. Methods: The Kids’ Inpatient Database (KID; 2003, 2006, 2009, 2012) and the Nationwide Inpatient Sample (NIS; ...
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evaluation of clinical characteristics of Kawasaki Syndrome and risk factors for coronary artery abnormalities among children in denmark
Acta Paediatrica, 2013Co-Authors: Amy Patel, Robert C. Holman, Lawrence B. Schonberger, Laura S Callinan, Nandini Sreenivasan, Thea Kolsen Fischer, Ermias D. BelayAbstract:Aim To examine clinical characteristics, treatment and outcome of Kawasaki Syndrome patients in Denmark. Methods A retrospective chart review of hospitalization records for children <15 years of age with a Kawasaki Syndrome discharge diagnosis identified through the Danish National Patient Registry during 1994 through June 2008 was conducted. Results A total of 284 cases <15 years of age were identified as Kawasaki Syndrome (n = 279) and atypical Kawasaki Syndrome (n = 5); 70.4% were <5 years of age and 64.4% were male. Most patients (91.5%; 258/282) were treated with intravenous immunoglobulin and 74.6% of these patients (191/256) received intravenous immunoglobulin before the 10th day of illness. A total of 37 (13.3%) Kawasaki Syndrome patients were diagnosed with coronary artery abnormalities. Not receiving intravenous immunoglobulin treatment before the 10th day of illness, young age and male sex were significantly associated with the development of coronary artery abnormalities. Conclusions In Denmark, more than one in 10 children with Kawasaki Syndrome develop coronary artery abnormalities. Physicians should increase their index of suspicion for early diagnosis and treatment of Kawasaki Syndrome among patients susceptible to increased risk of coronary artery abnormalities, particularly in infants who may have a more atypical presentation of the illness.
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Evaluation of clinical characteristics of Kawasaki Syndrome and risk factors for coronary artery abnormalities among children in Denmark.
Acta paediatrica (Oslo Norway : 1992), 2013Co-Authors: Amy Patel, Robert C. Holman, Lawrence B. Schonberger, Laura S Callinan, Nandini Sreenivasan, Thea Kolsen Fischer, Ermias D. BelayAbstract:Aim To examine clinical characteristics, treatment and outcome of Kawasaki Syndrome patients in Denmark. Methods A retrospective chart review of hospitalization records for children
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Kawasaki Syndrome in Denmark.
The Pediatric infectious disease journal, 2007Co-Authors: Thea K. Fischer, Robert C. Holman, Krista L. Yorita, Ermias D. Belay, Mads Melbye, Anders KochAbstract:Objective:To describe the epidemiologic characteristics of Kawasaki Syndrome (KS) and to estimate national KS incidence rates among children in Denmark.Methods:A retrospective population-based study using hospital discharge records with a KS diagnosis for children younger than 15 years selected from
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Kawasaki Syndrome hospitalizations in ireland 1996 through 2000
Pediatric Infectious Disease Journal, 2003Co-Authors: Maureen Lynch, Robert C. Holman, Ermias D. Belay, Aisling Mulligan, Lawrence B. SchonbergerAbstract:Objective.To describe the epidemiologic characteristics and estimate the incidence of Kawasaki Syndrome (KS) among children in Ireland.Methods.Hospital discharge records with a KS diagnosis among patients <18 years of age were examined using Ireland’s Hospital In-Patient Enquiry database for 1996 th
Donato Rigante - One of the best experts on this subject based on the ideXlab platform.
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A master role for neutrophils in Kawasaki Syndrome.
Immunology letters, 2017Co-Authors: Laura Andreozzi, Benedetta Bracci, Francesca D’errico, Donato RiganteAbstract:An increased white blood cell count is a hallmark of active Kawasaki Syndrome (KS) and has been suggested as a risk factor for cardiovascular morbidity by several investigators. Morphologic analysis of polymorphonuclear cells (PMNs) represents an accessible tool that is worth validating prospectively in a larger study to predict KS severity and poor response to intravenous immunoglobulin. More precisely, PMNs might be culprits in the development of KS and its complications, but they are not the only cells involved in this systemic vasculitis: further in-depth analysis will probably unravel the tangled pathogenesis of KS and find new targets for a more specific therapy
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The role of infection in Kawasaki Syndrome.
The Journal of infection, 2013Co-Authors: Nicola Principi, Donato Rigante, Susanna EspositoAbstract:Summary Objectives To analyse the evidence suggesting a possible infectious origin of Kawasaki Syndrome (KS). Methods PubMed was searched for all of the studies published over the last 15 years using the key words "Kawasaki Syndrome" or "mucocutaneous lymph node Syndrome" and "infectious disease" or "genetics" or "vasculitis" or "pathogenesis". Results Various levels of evidence support the hypothesis that KS is a complex disease triggered by an infection due to one or more pathogens. Viruses or bacteria may be the primum movens , although no specific infectious agent can be considered definitely etiological. A number of genetic polymorphisms have been identified in subjects with KS, but none of them can currently be considered a real marker of susceptibility. Conclusions Various data suggest that KS is intimately related to infectious diseases and that its clinical expression is influenced by predisposing genetic backgrounds, but our knowledge of the infectious agent(s) involved and the genetic characteristics of susceptible children remains only partial. Further studies are needed to address the many still open questions concerning the disease.
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Kawasaki Syndrome and concurrent Coxsackie virus B3 infection
Rheumatology International, 2012Co-Authors: Donato Rigante, Piero Valentini, Angelica Bibiana Delogu, Luca Cantarini, Marco Piastra, Donatella Francesca Angelone, Manuela Pardeo, Danilo Buonsenso, Daniele Serranti, Alessia De NiscoAbstract:We describe two previously healthy children who were hospitalized in the same period in different departments of our University with clinical signs of Kawasaki Syndrome, which were treated with intravenous immunoglobulins and acetylsalicylic acid: in both cases, Coxsackie virus infection was concurrently demonstrated by enzyme-linked immunosorbent assay, and complement fixation test identified antibodies to serotype B3. In the acute phase, both patients presented hyperechogenic coronary arteries, but no cardiologic sequels in the mid term. The etiological relationship between Kawasaki Syndrome and Coxsackie viruses is only hypothetical; however, the eventual identification of ad hoc environmental triggers is advisable in front of children with Kawasaki Syndrome, with the aim of optimizing epidemiological surveillance and understanding the intimate biological events of this condition.
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Incomplete Kawasaki Syndrome followed by systemic onset-juvenile idiopathic arthritis mimicking Kawasaki Syndrome.
Rheumatology international, 2009Co-Authors: Donato Rigante, Piero Valentini, Roberta Onesimo, D.f. Angelone, Alessia De Nisco, Giulia Bersani, Angelica Bibiana DeloguAbstract:A 3-month-old child was first treated for incomplete Kawasaki Syndrome with three cycles of intravenous immunoglobulins and aspirin, then with methylprednisolone which led to fever remission. The same child was re-hospitalized after a 10-month-period of well-being for the suspicion of a new episode of Kawasaki Syndrome, which appeared to be immunoglobulin-resistant: extensive testing failed to provide an alternative diagnosis of any infectious or infiltrative disease. Diagnosis of systemic onset-juvenile idiopathic arthritis was postulated upon the long persistence of fever and inflammatory signs, which subsided only after starting corticosteroid treatment.
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Lung parenchymal consolidation as an uncommon presentation and cause of delayed diagnosis in atypical Kawasaki Syndrome.
Rheumatology international, 2008Co-Authors: Francesco De Maddi, Donato Rigante, Roberto Cinelli, Gianfranco Mazzarella, P. SianiAbstract:We report three patients who initially showed prolonged fever, lung parenchymal consolidation and laboratory findings of pneumonia, and secondarily presented a clinical picture ascribed to Kawasaki Syndrome. Two of these children developed coronary artery dilations, which regressed upon echocardiography after 12 months. In the case of infants showing broncho-pulmonary abnormalities with slow resolution, active inflammatory parameters and high fever persistence, pediatricians should consider atypical Kawasaki Syndrome as a possible alternative diagnosis.