CARRA Newsletter-August 2017 Issue 1

What Caught our Eye: Kawasaki Disease…Incomplete, or…not?

Brian Feldman, MD, MSc, FRCPC
University of Toronto – The Hospital for Sick Children

I know that the rheumatology service isn’t involved in the treatment of most Kawasaki Disease patients at many centres. At SickKids, though, we are. Our team sees somewhere around 150 patients with KD a year.

I hear commonly, mostly from fellows who join us from other centres, that when it comes to KD, the faculty at SickKids tends to err on the side of over-treatment. How can one over-treat a condition for which randomized trials clearly indicate an important benefit of treatment? The newly arrived fellows imply that we over-diagnose.

Over-diagnosis and treatment with a completely benign therapy wouldn’t be a problem. However, the most commonly used therapy – intravenous immunoglobulin – is both costly and potentially harmful.

The diagnosis of Kawasaki Disease was originally made using the mucocutaneous lymph node syndrome (MCLS) criteria, of which you needed 5 of 6. As a “syndrome”, the call was easy. You either met the syndrome definition, or not.

By the early 1980s, though, it was recognized that there were children, who had developed coronary aneurysms typical for KD, who hadn’t met the MCLS criteria. They were labelled as having “atypical Kawasaki Disease.” A requirement for this diagnosis was having coronary aneurysms. Read More>>

BE A GUEST NEWSLETTER CONTRIBUTOR!
If you would like to contribute an article (related to pediatric rheumatology research) to our newsletter, we would love to hear from you! Please email [email protected] with details.

Announcements and Reminders

CARRA Large and Small Grant Submissions Deadlines Coming Up
CARRA Large and Small grants online submission form will be live by late-August. An email to all members will be sent when the online form is live. For more information about CARRA grants and submission requirements, check out the Grants page on the CARRA website.

CARRA Large Grant Deadlines

• Letter of Intent: 9/1
• Applications: 10/1

CARRA Small Grant Deadlines

• Applications: 10/1

CARRA Registry Update

3,596 Total Enrollment

STOP-JIA (Start Time Optimization of biologics in Poly-JIA)

233 of 400 Patients Enrolled
(24 with biosamples)

**

FROST (FiRst Line Options in Systemic JIA Treatment)

17 of 200 Patients Enrolled
(5 with biosamples)

**

PEPR

11 of 450 Patients Enrolled