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  1. Article ; Online: Is multisystem inflammatory syndrome in children on the Kawasaki syndrome spectrum?

    Yeung, Rae Sm / Ferguson, Polly J

    The Journal of clinical investigation

    2020  Volume 130, Issue 11, Page(s) 5681–5684

    Abstract: An alarming increase in children presenting with fever, hyperinflammation, and multiorgan dysfunction frequently requiring intensive care has been observed after severe acute respiratory syndrome coronavirus 2 infection. The illness resembles Kawasaki ... ...

    Abstract An alarming increase in children presenting with fever, hyperinflammation, and multiorgan dysfunction frequently requiring intensive care has been observed after severe acute respiratory syndrome coronavirus 2 infection. The illness resembles Kawasaki disease (KD), with coronary dilatation and aneurysm occurring in some. However, the cardiovascular manifestations were typically on the severe end of the KD spectrum, with cardiogenic shock a common presentation together with other features. This led to defining a unique syndrome named multisystem inflammatory syndrome in children (MIS-C). In this issue of the JCI, Lee and Day-Lewis et al. and Diorio et al. explored the clinical profiles associated with coronavirus disease 2019 in children. We posit that while splitting MIS-C into a separate disease may aid clinical management decisions, lumping it into the KD pot may better serve to understand pathobiology.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections ; Humans ; Mucocutaneous Lymph Node Syndrome/complications ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome
    Keywords covid19
    Language English
    Publishing date 2020-07-30
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 3067-3
    ISSN 1558-8238 ; 0021-9738
    ISSN (online) 1558-8238
    ISSN 0021-9738
    DOI 10.1172/JCI141718
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  2. Article ; Online: [No title information]

    Tam, Herman / El Tal, Tala / Go, Ellen / Yeung, Rae Sm

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2020  Volume 192, Issue 48, Page(s) E1686–E1690

    Title translation Le syndrome inflammatoire multisystémique de l’enfant ayant un lien temporel avec la COVID-19 : multiples visages, multiples appellations.
    Language French
    Publishing date 2020-11-20
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.201600-f
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  3. Article ; Online: Long-term use and remission of granulomatosis with polyangiitis with the oral C5a receptor inhibitor avacopan.

    Ennis, Daniel / Yeung, Rae Sm / Pagnoux, Christian

    BMJ case reports

    2020  Volume 13, Issue 10

    Abstract: Granulomatosis with polyangiitis (GPA) is a rare antineutrophil cytoplasm antibody-associated vasculitis. Several therapeutic advances have occurred over the past two decades, but relapse rate remains high and refractory cases are not uncommon. Here, we ... ...

    Abstract Granulomatosis with polyangiitis (GPA) is a rare antineutrophil cytoplasm antibody-associated vasculitis. Several therapeutic advances have occurred over the past two decades, but relapse rate remains high and refractory cases are not uncommon. Here, we present the case of a female patient diagnosed with GPA at the age of 9 years with a severe, multirelapsing disease course which failed to adequately respond to conventional therapies. Avacopan, a novel C5a receptor inhibitor, was started based on phase II studies that showed promise as a steroid-sparing adjunct. The patient was able to successfully reduce her glucocorticoid dose and reduce her immunosuppressive treatments without another flare. She has been on avacopan for 35 months, had no adverse events that required its discontinuation, and her disease is in sustained remission.
    MeSH term(s) Administration, Oral ; Aniline Compounds/administration & dosage ; Child ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Granulomatosis with Polyangiitis/diagnosis ; Granulomatosis with Polyangiitis/drug therapy ; Humans ; Nipecotic Acids/administration & dosage ; Receptor, Anaphylatoxin C5a/antagonists & inhibitors ; Remission Induction/methods ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
    Chemical Substances Aniline Compounds ; Nipecotic Acids ; Receptor, Anaphylatoxin C5a ; avacopan (O880NM097T)
    Language English
    Publishing date 2020-10-29
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-236236
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  4. Article: Is multisystem inflammatory syndrome in children on the Kawasaki syndrome spectrum?

    Yeung, Rae Sm / Ferguson, Polly J

    J Clin Invest

    Abstract: An alarming increase in children presenting with fever, hyperinflammation, and multiorgan dysfunction frequently requiring intensive care has been observed after severe acute respiratory syndrome coronavirus 2 infection. The illness resembles Kawasaki ... ...

    Abstract An alarming increase in children presenting with fever, hyperinflammation, and multiorgan dysfunction frequently requiring intensive care has been observed after severe acute respiratory syndrome coronavirus 2 infection. The illness resembles Kawasaki disease (KD), with coronary dilatation and aneurysm occurring in some. However, the cardiovascular manifestations were typically on the severe end of the KD spectrum, with cardiogenic shock a common presentation together with other features. This led to defining a unique syndrome named multisystem inflammatory syndrome in children (MIS-C). In this issue of the JCI, Lee and Day-Lewis et al. and Diorio et al. explored the clinical profiles associated with coronavirus disease 2019 in children. We posit that while splitting MIS-C into a separate disease may aid clinical management decisions, lumping it into the KD pot may better serve to understand pathobiology.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #691305
    Database COVID19

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  5. Article: Kawasaki disease: High index of suspicion needed in a febrile child.

    Scuccimarri, Rosie / Yeung, Rae Sm

    Paediatrics & child health

    2014  Volume 19, Issue 5, Page(s) 239–240

    Language English
    Publishing date 2014-05-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2106767-3
    ISSN 1918-1485 ; 1205-7088
    ISSN (online) 1918-1485
    ISSN 1205-7088
    DOI 10.1093/pch/19.5.239
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  6. Article ; Online: Evaluating the time-varying risk of hypertension, cardiac events, and mortality following Kawasaki disease diagnosis.

    Lee, Jennifer J Y / Feldman, Brian M / McCrindle, Brian W / Li, Ping / Yeung, Rae Sm / Widdifield, Jessica

    Pediatric research

    2022  Volume 93, Issue 5, Page(s) 1439–1446

    Abstract: Background: This study evaluated the risk of hypertension, major adverse cardiac events (MACE), and all-cause mortality in Kawasaki disease (KD) patients up to young adulthood.: Methods: An inception cohort of 1169 KD patients between 1991 and 2008 ... ...

    Abstract Background: This study evaluated the risk of hypertension, major adverse cardiac events (MACE), and all-cause mortality in Kawasaki disease (KD) patients up to young adulthood.
    Methods: An inception cohort of 1169 KD patients between 1991 and 2008 from a tertiary-level hospital in Ontario, Canada was linked with health administrative data to ascertain outcomes up to 28 years of follow-up. Their risk was compared with 11,690 matched population comparators. The primary outcome was hypertension and secondary outcomes were MACE and death.
    Results: After a median follow-up of 20 years [IQR: 8.3], the cumulative incidence of hypertension and MACE in the KD group was 3.8% (95% CI: 2.5-5.5) and 1.2% (95% CI: 0.6-2.4%), respectively. The overall survival probability in the KD group was 98.6% (95% CI: 97.2-99.3%). Relative to comparators, KD patients were at an increased risk for hypertension [aHR: 2.2 (95% CI: 1.5-3.4)], death [aHR: 2.5 (95% CI: 1.3-5.0)], and MACE [aHR: 10.7 (95% CI: 6.4-17.9)]. For hypertension and MACE, the aHR was the highest following diagnosis and then the excess risk diminished after 16 and 13 years of follow-up, respectively. MACE occurred largely in KD patients with coronary aneurysms [cumulative incidence: 12.8%].
    Conclusions: KD patients demonstrated a reassuring cardiac prognosis up to young adulthood with low events and excellent survival. KD patients were at increased risk for hypertension, but this excess risk occurred early and declined with time.
    Impact: With the current standard of care, KD patients demonstrated favorable cardiac prognosis, with low events of hypertension, MACE, and excellent survival. Hypertension and MACE risk appear to be highest around the time of KD diagnosis. MACE occurred primarily in KD patients with coronary aneurysms. Our findings are reassuring to KD patients, families, and their providers. Our study demonstrated an association between KD exposure and hypertension. This association is relatively novel. Previous studies have remained conflicting if KD contributes to long-term atherosclerotic risk.
    MeSH term(s) Humans ; Young Adult ; Adult ; Coronary Aneurysm/complications ; Coronary Aneurysm/diagnosis ; Mucocutaneous Lymph Node Syndrome/complications ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Hypertension/complications ; Hypertension/diagnosis ; Incidence ; Ontario/epidemiology ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2022-08-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-022-02273-8
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    Zs.A 564: Show issues Location:
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    Zs.MO 373: Show issues

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  7. Article ; Online: The role of Inositol 1,4,5 triphosphate kinase C in the pathogenesis of Kawasaki disease

    Yeung Rae SM / Khajoee Vahid

    Pediatric Rheumatology, Vol 9, Iss Suppl 1, p P

    2011  Volume 295

    Keywords Diseases of the musculoskeletal system ; RC925-935 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Pediatrics ; RJ1-570 ; DOAJ:Pediatrics
    Language English
    Publishing date 2011-09-01T00:00:00Z
    Publisher BioMed Central
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Predictors of delayed treatment of Kawasaki disease in community and tertiary care hospitals

    Luca Nadia / Ching Joyce CY / Manlhiot Cedric / McCrindle Brian W / Yeung Rae SM

    Pediatric Rheumatology, Vol 10, Iss Suppl 1, p A

    2012  Volume 89

    Keywords Diseases of the musculoskeletal system ; RC925-935 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Pediatrics ; RJ1-570 ; DOAJ:Pediatrics
    Language English
    Publishing date 2012-07-01T00:00:00Z
    Publisher BioMed Central
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Reply.

    Aeschlimann, Florence A / Yeung, Rae S M / Barra, Lillian / Benseler, Susanne M

    Arthritis & rheumatology (Hoboken, N.J.)

    2019  Volume 71, Issue 5, Page(s) 836–838

    MeSH term(s) Adult ; Child ; Disease Progression ; Humans ; Takayasu Arteritis
    Language English
    Publishing date 2019-03-06
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2756371-6
    ISSN 2326-5205 ; 2326-5191
    ISSN (online) 2326-5205
    ISSN 2326-5191
    DOI 10.1002/art.40824
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    Zs.A 24: Show issues Location:
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  10. Article ; Online: What matters most to pediatric rheumatologists in deciding whether to discontinue biologics in a child with juvenile idiopathic arthritis? A best-worst scaling survey.

    Currie, Gillian R / Groothuis-Oudshoorn, Catherina G M / Twilt, Marinka / Kip, Michelle M A / IJzerman, Maarten J / Benseler, Susanne M / Swart, Joost F / Vastert, Sebastiaan J / Wulffraat, Nico M / Yeung, Rae / Marshall, Deborah A

    Clinical rheumatology

    2023  Volume 42, Issue 8, Page(s) 2173–2180

    Abstract: Objectives: Care for JIA patients has been transformed in the biologics era; however, biologics carry important (although rare) risks and are costly. Flares after biological withdrawal are seen frequently, yet there is little clinical guidance to ... ...

    Abstract Objectives: Care for JIA patients has been transformed in the biologics era; however, biologics carry important (although rare) risks and are costly. Flares after biological withdrawal are seen frequently, yet there is little clinical guidance to identify which patients in clinical remission can safely have their biologic discontinued (by stopping or tapering). We examined what characteristics of the child or their context are important to pediatric rheumatologists when making the decision to discuss withdrawal of biologics.
    Methods: We conducted a survey including a best-worst scaling (BWS) exercise in pediatric rheumatologists who are part of the UCAN CAN-DU network to assess the relative importance of 14 previously identified characteristics. A balanced incomplete block design was used to generate choice tasks. Respondents evaluated 14 choice sets of 5 characteristics of a child with JIA and identified for each set which was the most and least important in the decision to offer withdrawal. Results were analyzed using conditional logit regression.
    Results: Fifty-one (out of 79) pediatric rheumatologists participated (response rate 65%). The three most important characteristics were how challenging it was to achieve remission, history of established joint damage, and time spent in remission. The three least important characteristics were history of temporomandibular joint involvement, accessibility of biologics, and the patient's age.
    Conclusions: These findings give quantitative insight about factors important to pediatric rheumatologists' decision-making about biologic withdrawal. In addition to high quality clinical evidence, further research is needed to understand the perspective of patients and families to inform shared decision-making about biologic withdrawal for JIA patients with clinically inactive disease. Key Points ● What is already known on this topic-there is limited clinical guidance for pediatric rheumatologists in making decisions about biologic withdrawal for patients with juvenile idiopathic arthritis who are in clinical remission. ● What this study adds-this study quantitatively examined what characteristic of the child in clinical remission, or of their context, are most important to pediatric rheumatologists in deciding whether to offer withdrawal of biologics. ● How this study might affect research, practice or policy-understanding of these characteristics can provide useful information to other pediatric rheumatologists in making their decisions, and may guide areas to focus on for future research.
    MeSH term(s) Humans ; Child ; Arthritis, Juvenile/drug therapy ; Antirheumatic Agents/therapeutic use ; Rheumatologists ; Surveys and Questionnaires ; Biological Products/therapeutic use
    Chemical Substances Antirheumatic Agents ; Biological Products
    Language English
    Publishing date 2023-05-19
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-023-06616-6
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