2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease

作者：Mark Gorelik, Sharon A. Chung, Kaveh Ardalan, Bryce A. Binstadt, Kevin G. Friedman, Kristen Hayward, Lisa F. Imundo, Sivia Lapidus, Susan Kim, Mary Beth F. Son, Sangeeta Sule, Adriana H. Tremoulet, Heather Van Mater, Cagri Yildirim‐Toruner, Carol A. Langford, Mehrdad Maz, Andy Abril, Gordon Guyatt, Amy M. Archer, Doyt L. Conn, Kathy A. Full, Peter C. Grayson, Maria Ibarra, Peter A. Merkel, Rennie L. Rhee, Philip Seo, John H. Stone, Robert P. Sundel, Omar I. Vitobaldi, Ann Warner, Kevin Byram, Anisha B. Dua, Nedaa Husainat, Karen James, Mohamad A. Kalot, Yih Chang Lin, Jason Springer, Marat Turgunbaev, Alexandra Villa‐Forte, Amy S. Turner, Reem A. Mustafa · 发表于：Arthritis & Rheumatology · 年份：2022 · DOI：10.1002/art.42041 · 被引用次数：39 · 研究领域：Kawasaki Disease and Coronary Complications、Autoimmune and Inflammatory Disorders Research、Vasculitis and related conditions

OBJECTIVE: To provide evidence-based recommendations and expert guidance for the management of Kawasaki disease (KD), focusing on clinical scenarios more commonly addressed by rheumatologists. METHODS: Sixteen clinical questions regarding diagnostic testing, treatment, and management of KD were developed in the Patient/Population, Intervention, Comparison, and Outcomes (PICO) question format. Systematic literature reviews were conducted for each PICO question. We used the Grading of Recommendations, Assessment, Development and Evaluation method to assess the quality of evidence and formulate recommendations. Each recommendation required consensus from at least 70% of the Voting Panel. RESULTS: We present 1 good practice statement, 11 recommendations, and 1 ungraded position statement to guide the management of KD and clinical scenarios of suspected KD. These recommendations for KD are focused on situations in which input from rheumatologists may be requested by other managing specialists, such as in cases of treatment-refractory, severe, or complicated KD. The good practice statement affirms that all patients with KD should receive initial treatment with intravenous immunoglobulin (IVIG). In addition, we developed 7 strong and 4 conditional recommendations for the management of KD or suspected KD. Strong recommendations include prompt treatment of incomplete KD, treatment with aspirin, and obtaining an echocardiogram in the setting of unexplained macrophage activation syndrom...