Diagnostic approaches to Kawasaki disease worldwide: the results from the JIR-CliPS network
Rheumatology (Oxford, England), cilt.65, sa.7, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 65 Sayı: 7
- Basım Tarihi: 2026
- Doi Numarası: 10.1093/rheumatology/keag340
- Dergi Adı: Rheumatology (Oxford, England)
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: clinical practice, coronary artery, diagnostic approaches, Kawasaki disease, survey, worldwide
- Hacettepe Üniversitesi Adresli: Evet
Özet
OBJECTIVES: To evaluate worldwide differences of diagnostic approaches to Kawasaki disease (KD), focusing on aspects, which vary throughout major international guidelines, including criteria for diagnostic and risk stratification. METHODS: An online English-language survey was distributed to physicians worldwide between June 2022 and November 2024 through the JIR-CliPS (juvenile inflammatory rheumatism; clinical practice strategies) network, aiming to collect real-life diagnostic and management practices in juvenile rheumatic conditions, including KD. Responses addressing the definitions of complete and incomplete KD and criteria identifying patients at high-risk for coronary artery lesions (CALs), were analysed. Descriptive statistics, comparisons of categorical variables, sensitivity and weighted analysis were performed. RESULTS: One hundred and ninety-two physicians from 51 countries completed the survey. All respondents accepted ≥5 days of fever plus four criteria as diagnostic for complete KD. Thirty-two percent (n = 62/192, 95% CI [25.74, 39.40]) also accepted shorter fever duration, particularly physicians from France (n = 16/24, 63%, 95% CI [44.68, 84.37]). Ninety-four percent (n = 178/189, 95% CI [89.83, 97.06]) diagnosed incomplete KD based on fever and three clinical criteria. Forty-four percent (n = 84/189, 95% CI [37.23, 51.83]) accepted the presence of CALs as diagnostic in febrile patients, even without other clinical criteria; this approach was more common among Europeans. Infant age and elevated coronary Z-scores were identified as key indicators for coronary involvement. Years of experience did not influence the results. CONCLUSION: Despite shared core diagnostic principles, country-specific differences persist in real-life clinical practice regarding fever duration, minimum clinical criteria and the role of coronary artery findings in diagnosing complete and incomplete KD. Future real-life studies are needed to support timely and consistent diagnosis.