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Management of Kawasaki disease
Kawasaki disease is an acute self limiting inflammatory disorder, associated with vasculitis, affecting predominately middle sized arteries, particularly the coronary arteries. It affects 8.1/100 000 children under age 5 years in the UK and is the commonest cause acquired heart disease in children in developed countries. The aetiology is unknown and felt to reflect an infective trigger inducing an inflammatory response in a genetically susceptible host. Genetic studies have identified susceptibility genes and genes that influence response to treatment. Eleftheriou and colleagues discuss the recent advances in aetiology and their impact on treatment. The use IVIG and aspirin are well established. The authors discuss the use of corticosteroids (and monoclonal antibody therapy) in severe cases/treatment resistant cases including discussion of scoring systems at presentation which predict response to treatment. This up to date guidance puts the advances in aetiology and management in context, advocates multicentre research looking at treatment and outcome and is essential reading for clinicians who diagnose, assess and manage this condition. See page 74
Neuropathic pain in childhood
The important issue of neuropathic pain in childhood is discussed in a comprehensive review by Richard Howard and colleagues. Neuropathic pain …
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