Kawasaki aneurysms tracked with late IVIG, IVIG resistance and age under six months

The edition in brief

Among 533 children treated for Kawasaki disease at an Italian referral centre since 1982, 22% had acute coronary involvement but only 27 developed aneurysms, and persistent abnormalities occurred only with medium or giant aneurysms. Aneurysm was independently associated with IVIG resistance (OR 9.89), age under six months (OR 7.64), IVIG after day 10 (OR 5.27) and pericardial effusion (OR 3.16). Early recognition, especially of incomplete disease in young infants, and prompt escalation are the modifiable steps. The Australian FH registry of 341 children found diagnosis at a mean age of 11.9, genetic testing in half, LDL goals met in 48% and lipoprotein(a) measured in a third. Two UK hospitals' data on 85 young people admitted for medical stabilisation of restrictive eating disorders showed a median 21-day stay, refeeding syndrome in 24% and nasogastric feeding in 30%. A Hong Kong trial in 128 children aged 6 to 12 found immersive virtual reality before first chemotherapy reduced anxiety with large effect sizes and cut anticipatory nausea and vomiting. A phase III crossover trial of dichloroacetate in 34 children with PDC deficiency missed its primary motor end point, with signals only in the open-label extension.