{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:26:19Z","timestamp":1793571979032,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":356,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["19H03904"],"award-info":[{"award-number":["19H03904"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The treatment guidelines for acute Kawasaki disease (KD) have been revised several times. Moreover, the criterion used to define coronary artery abnormalities (CAAs) has changed from the coronary artery's internal diameter to the\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score. Treatment for KD and methods for evaluating CAAs vary between hospitals, so we investigated the actual status of acute KD treatment and development of CAAs under the 2012 Japanese treatment guidelines for acute KD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The 24th Japanese Nationwide Survey on Kawasaki Disease yielded 2618 patients who developed KD in the Kinki area in 2016. We sent a secondary questionnaire to each participating hospital and used the resulting data to investigate the frequency of CAAs according to\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score, treatment by KD treatment stage, and predictors of CAAs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The response rate was 80.0%. The data for 1426 patients without major data deficiencies were examined. The frequency of CAAs was 3.0% when based on coronary artery internal diameters and 8.8% when based on\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores. Intravenous immunoglobulins combined with corticosteroids were administered as an initial treatment in 12.8% of cases and as a second\u2010line treatment in 16.8% of cases. Corticosteroids, cyclosporine A, infliximab, and plasma exchange were used at similar frequencies for third\u2010line treatment. A pretreatment maximum coronary artery\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score of \u22651.9 and age &lt;1\u2009year were associated with significantly higher incidences of CAAs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Using the\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score resulted in a threefold increase in the number of patients diagnosed with CAAs. A pretreatment maximum coronary artery\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score of \u22651.9 and age &lt;1\u2009year are useful predictors of CAAs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.15391","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T11:57:03Z","timestamp":1666094223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Status of treatment and outcome in Kawasaki disease in the Kinki area of Japan"],"prefix":"10.1111","volume":"64","author":[{"given":"Tomoya","family":"Tsuchihashi","sequence":"first","affiliation":[{"name":"Society of Kinki Area Kawasaki Disease Research  Suita city Osaka Japan"},{"name":"Department of Pediatrics Wakayama Medical University  Wakayama 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Society of Kinki Area Kawasaki Disease Research  Suita city Osaka Japan"},{"name":"Department of Pediatrics Kansai Medical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6654-1481","authenticated-orcid":false,"given":"Yoshikazu","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Public Health Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0831-8008","authenticated-orcid":false,"given":"Hiroyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Society of Kinki Area Kawasaki Disease Research  Suita city Osaka Japan"},{"name":"Department of Pediatrics Wakayama Medical University  Wakayama Japan"},{"name":"Department of Pediatrics Wakayama Tsukushi Medical and Welfare Center  Iwade Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the steering committee of the Society of Kinki Area Kawasaki Disease Research","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.05.034"},{"key":"e_1_2_10_3_1","first-page":"54","article-title":"Guidelines for medical treatment of acute Kawasaki disease [in Japanese]","volume":"20","author":"Research Committee of the Japanese Society of Pediatric Cardiology and Cardiac Surgery","year":"2003","journal-title":"Pediatr Cardiol Cardiac 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