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Diseases of Blood vessels
Published in P. Chopra, R. Ray, A. Saxena, Illustrated Textbook of Cardiovascular Pathology, 2013
Kawasaki syndrome also known as mucocutaneous lymph node syndrome, is a febrile illness which affects infants and children below five years of age. It is characterized by vasculitis of the medium sized arteries with frequent involvement of the coronary arteries. Latter present as ectasia, aneurysm which may rupture or show thrombosis. Consequently myocardial infarction and sudden death can occur. In addition to arteritis, reddening and desquamation of palms and soles, a maculo-papular rash, conjunctival congestion, reddening of lips and tongue and nonpurulent cervical lympha-denopathy are often associated. Microscopically, marked necrosis and inflammation in the entire thickness of the vessel wall is observed. Destruction of the vessel wall predisposes to aneurysm formation. Etiology of Kawasaki is not clearly understood. The various possibilities include immunological injury by way of both humoral and cell mediated mechanisms. Autoantibodies to endothelial and smooth muscle cells have been demonstrated which possibly result in acute vasculitis.
Effects of adjunct treatment with intravenous immunoglobulins on the course of severe COVID-19: results from a retrospective cohort study
Published in Current Medical Research and Opinion, 2021
Figen Esen, Perihan E. Özcan, Günseli Orhun, Özlem Polat, İlkay Anaklı, Gülçin Alay, Verda Tuna, Emre Çeliksoy, Mehmet Kılıç, Mutlu Mercan, Tufan Tukek
In the absence of specific vaccines and drugs for COVID-19, off-label use of existing medications, most often in a complementary combined approach, has become legitimate practice during the pandemic. Among those existing medications used for COVID-19 are intravenous immunoglobulins (IVIGs) which are known for their anti-inflammatory effects and approved in several immune mediated disorders, including Kawasaki syndrome. Such disorders have increasingly been reported also in association with COVID-191–5. Passive antibody therapy by transfusion of convalescent sera, as used during previous coronavirus outbreaks, has been mandated for COVID-19 as well6–8 and recently two marketed IVIG products, Gamunex-Ci and Flebogammaii, were shown to react with SARS-CoV 2 antigens in vitro9. In line with all this, there have been case reports of COVID-19 patients who benefited not only from passive antibody therapy10,11 but also from IVIG treatment12–16.
The Role of Anti-IL-1 Treatment in MIS-C Patients
Published in Expert Opinion on Biological Therapy, 2022
Maria Vincenza Mastrolia, Edoardo Marrani, Ilaria Maccora, Ilaria Pagnini, Gabriele Simonini
In the early phases of the pandemic, this inflammatory syndrome was associated with Kawasaki syndrome (KS) due to the sharing clinical findings as prolonged fever, mucocutaneous manifestations and frequent cardiac involvement. Subsequent data from epidemiological and clinical observations during the furthermore period suggested some differences: a remarkable frequency in African and Hispanic ethnic groups, a higher average age of onset and the presence of gastrointestinal symptoms sometimes so severe as to simulate a surgical emergency. However, the cardiac involvement has shown peculiar characteristics, as it is more often associated with myocardial damage, ventricular dysfunction, hypotension, and poor perfusion [1–4].
Early-term Optical Coherence Tomography Angiographic Findings in Pediatric Patients Infected with COVID-19
Published in Ocular Immunology and Inflammation, 2023
Özge Begüm Comba, Muharrem Karakaya, Sinan Albayrak, Elvan Yalçın
SARS-CoV-2 virus is a novel coronavirus that can cause multiple system infections, but mainly respiratory infections such as severe acute respiratory syndrome.1 At the beginning of the pandemic, COVID-19 infection in children was observed to have a lower incidence, and a more favorable clinical presentation and prognosis compared to adults. However, with the progression of the pandemic, toxic shock and Kawasaki syndrome-like multi-organ failure conditions named “multisystem inflammatory syndrome in children (MIS-C)” began to develop.6–8 The multi-organ damage caused by COVID-19 infection has led to publications attempting to delineate the pathophysiology behind the various clinical manifestations.