Kawasaki disease triggered by Epstein-Barr virus infection
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Abstract
Kawasaki disease (KD) is the most common cause of acquired heart disease today. An important and enduring complication of KD is coronary aneurysm whose early diagnosis and treatment can reduce the risk from 25% to 3%. Diagnosis of this disease is mainly clinical, although leukocytosis, increased erythrocyte sedimentation rate, and echocardiography are helpful in diagnosis. The cause of KD remains unknown, but the most common hypothesis is an abnormal immune response that is likely caused by an infectious agent, possibly in a favorable genetic background and leads to vasculitis of the middle arteries especially, coronary arteries of the heart. Numerous infectious agents have been suggested in this regard. Co-infection with KD can also delay diagnosis. In this article, we introduce a 5 years and 7 months child who developed Kawasaki disease within a few days of the onset of Epstein-Barr virus infection.
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2- Yanagawa H, Nakamura Y, Yashiro M, Ojima T, Tanihara S, Oki I, et al. Results of the nationwide epidemiologic survey of Kawasaki disease in 1995 and 1996 in Japan. Pediatrics. 1998 Dec. 102(6):E65.
3- Yanagawa H, Yashiro M, Nakamura Y, Kawasaki T, Kato H. Epidemiologic pictures of Kawasaki disease in Japan: from the nationwide incidence survey in 1991 and 1992. Pediatrics. 1995 Apr. 95(4):475-9.
4- Pinna GS, Kafetzis DA, Tselkas OI, Skevaki CL. Kawasaki disease: an overview. Curr Opin Infect Dis. 2008 Jun. 21(3):263-70.
5- Holman RC, Christensen KY, Belay ED, Steiner CA, Effler PV, Miyamura J, Forbes S, et al. Racial/ethnic differences in the incidence of Kawasaki syndrome among children in Hawaii. Hawaii Med J. 2010;69:194–197.
6- Uehara R, Yashiro M, Nakamura Y, Yanagawa H. Kawasaki disease in parents and children. Acta Paediatr. 2003;92:694–697.
7- Dergun M, Kao A, Hauger SB, Newburger JW, Burns JC. Familial occurrence of Kawasaki syndrome in North America. Arch Pediatr Adolesc Med. 2005;159:876–881.
8- Onouchi Y. Genetics of Kawasaki disease: what we know and don’t know. Circ J. 2012;76:1581–1586.
9- Uehara R, Yashiro M, Nakamura Y, Yanagawa H. Clinical features of patients with Kawasaki disease whose parents had the same disease. Arch Pediatr Adolesc Med. 2004;158:1166–1169.
10- Onouchi Y, Gunji T, Burns JC, Shimizu C, Newburger JW, Yashiro M, Nakamura Y, et al. ITPKC functional polymorphism associated with Kawasaki disease Downloaded from susceptibility and formation of coronary artery aneurysms. Nat Genet. 2008;40:35–42.
11- Khor CC, Davila S, Shimizu C, Sheng S, Matsubara T, Suzuki Y, et al; US and International Kawasaki Disease Genetics Consortia. Genome-wide linkage and association mapping identify susceptibility alleles in ABCC4 for Kawasaki disease. J Med Genet. 2011;48:467–472.
12- Onouchi Y, Ozaki K, Buns JC, Shimizu C, Hamada H, Honda T, Terai M, et al. Common variants in CASP3 confer susceptibility to Kawasaki disease. Hum Mol Genet. 2010;19:2898–2906.
13- Onouchi Y, Ozaki K, Burns JC, Shimizu C, Terai M, Hamada H, et al; Japan Kawasaki Disease Genome Consortium; US Kawasaki Disease Genetics Consortium. A genome-wide association study identifies three new risk loci for Kawasaki disease. Nat Genet. 2012;44:517–521.
14- Mason WH, Takahashi M, Schneider T. Recurrence of Kawasaki disease in a large urban cohort in the United States. In: Takahashi M, Taubert K, eds. Proceedings of the Fourth International Symposium on Kawasaki Disease. Dallas, Tex: American Heart Association; 1993:21-6.
15- Son MBF, Newburger JW. Kawasaki Disease. Pediatr Rev. 2018 Feb. 39 (2):78-90.
16- Kikuta H, Matsumoto S, Osato T. Kawasaki disease and Epstein-Barr virus. Acta Paediatr Jpn. 1991 Dec;33(6):765-70.
17- Kanegane H, Tsuji T, Seki H, Yachie A, Yokoi T, Miyawaki T, et al. Kawasaki disease with a concomitant primary Epstein-Barr virus infection. Acta Paediatr Jpn. 1994 Dec;36(6):713-6.
18- Maggio MC, Fabiano C, Corsello G. Kawasaki disease triggered by EBV virus in a child with Familial Mediterranean Fever. Ital J Pediatr. 2019 Oct;45(1):129. doi: 10.1186/s13052-019-0717-8.
19- Ariza ME, Glaser R, Kaumaya PT, Jones C, Williams MV. The EBV-encoded dUTPase activates NF-kappa B through the TLR2 and MyD88-dependent signaling pathway. J Immunol. 2009;182:851–9.
20- Fuse S, Fujinaga E, Mori T, Hotsubo T, Kuroiwa Y, Morii M. Children with Kawasaki disease are not infected with Epstein-Barr virus. Pediatr Infect Dis J. 2010;29:286–7.
2- Yanagawa H, Nakamura Y, Yashiro M, Ojima T, Tanihara S, Oki I, et al. Results of the nationwide epidemiologic survey of Kawasaki disease in 1995 and 1996 in Japan. Pediatrics. 1998 Dec. 102(6):E65.
3- Yanagawa H, Yashiro M, Nakamura Y, Kawasaki T, Kato H. Epidemiologic pictures of Kawasaki disease in Japan: from the nationwide incidence survey in 1991 and 1992. Pediatrics. 1995 Apr. 95(4):475-9.
4- Pinna GS, Kafetzis DA, Tselkas OI, Skevaki CL. Kawasaki disease: an overview. Curr Opin Infect Dis. 2008 Jun. 21(3):263-70.
5- Holman RC, Christensen KY, Belay ED, Steiner CA, Effler PV, Miyamura J, Forbes S, et al. Racial/ethnic differences in the incidence of Kawasaki syndrome among children in Hawaii. Hawaii Med J. 2010;69:194–197.
6- Uehara R, Yashiro M, Nakamura Y, Yanagawa H. Kawasaki disease in parents and children. Acta Paediatr. 2003;92:694–697.
7- Dergun M, Kao A, Hauger SB, Newburger JW, Burns JC. Familial occurrence of Kawasaki syndrome in North America. Arch Pediatr Adolesc Med. 2005;159:876–881.
8- Onouchi Y. Genetics of Kawasaki disease: what we know and don’t know. Circ J. 2012;76:1581–1586.
9- Uehara R, Yashiro M, Nakamura Y, Yanagawa H. Clinical features of patients with Kawasaki disease whose parents had the same disease. Arch Pediatr Adolesc Med. 2004;158:1166–1169.
10- Onouchi Y, Gunji T, Burns JC, Shimizu C, Newburger JW, Yashiro M, Nakamura Y, et al. ITPKC functional polymorphism associated with Kawasaki disease Downloaded from susceptibility and formation of coronary artery aneurysms. Nat Genet. 2008;40:35–42.
11- Khor CC, Davila S, Shimizu C, Sheng S, Matsubara T, Suzuki Y, et al; US and International Kawasaki Disease Genetics Consortia. Genome-wide linkage and association mapping identify susceptibility alleles in ABCC4 for Kawasaki disease. J Med Genet. 2011;48:467–472.
12- Onouchi Y, Ozaki K, Buns JC, Shimizu C, Hamada H, Honda T, Terai M, et al. Common variants in CASP3 confer susceptibility to Kawasaki disease. Hum Mol Genet. 2010;19:2898–2906.
13- Onouchi Y, Ozaki K, Burns JC, Shimizu C, Terai M, Hamada H, et al; Japan Kawasaki Disease Genome Consortium; US Kawasaki Disease Genetics Consortium. A genome-wide association study identifies three new risk loci for Kawasaki disease. Nat Genet. 2012;44:517–521.
14- Mason WH, Takahashi M, Schneider T. Recurrence of Kawasaki disease in a large urban cohort in the United States. In: Takahashi M, Taubert K, eds. Proceedings of the Fourth International Symposium on Kawasaki Disease. Dallas, Tex: American Heart Association; 1993:21-6.
15- Son MBF, Newburger JW. Kawasaki Disease. Pediatr Rev. 2018 Feb. 39 (2):78-90.
16- Kikuta H, Matsumoto S, Osato T. Kawasaki disease and Epstein-Barr virus. Acta Paediatr Jpn. 1991 Dec;33(6):765-70.
17- Kanegane H, Tsuji T, Seki H, Yachie A, Yokoi T, Miyawaki T, et al. Kawasaki disease with a concomitant primary Epstein-Barr virus infection. Acta Paediatr Jpn. 1994 Dec;36(6):713-6.
18- Maggio MC, Fabiano C, Corsello G. Kawasaki disease triggered by EBV virus in a child with Familial Mediterranean Fever. Ital J Pediatr. 2019 Oct;45(1):129. doi: 10.1186/s13052-019-0717-8.
19- Ariza ME, Glaser R, Kaumaya PT, Jones C, Williams MV. The EBV-encoded dUTPase activates NF-kappa B through the TLR2 and MyD88-dependent signaling pathway. J Immunol. 2009;182:851–9.
20- Fuse S, Fujinaga E, Mori T, Hotsubo T, Kuroiwa Y, Morii M. Children with Kawasaki disease are not infected with Epstein-Barr virus. Pediatr Infect Dis J. 2010;29:286–7.
| Files | ||
| Issue | Vol 59, No 12 (2021) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v59i12.8069 | |
| Keywords | ||
| Etiology Epstein-Barr virus Kawasaki disease | ||
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How to Cite
1.
Hashemian H, Ashjari Y, Nazari E. Kawasaki disease triggered by Epstein-Barr virus infection. Acta Med Iran. 2021;59(12):743-746.
