Furthermore, the decision of initiation and duration of antiplatelet and anticoagulant agents should also be based on combination of dynamics of platelet activation, hemodynamic parameters and geometric dimension of aneurysm in KD

Furthermore, the decision of initiation and duration of antiplatelet and anticoagulant agents should also be based on combination of dynamics of platelet activation, hemodynamic parameters and geometric dimension of aneurysm in KD. Conflict of interest The authors declare no conflict of interest. Linifanib (ABT-869) Footnotes Peer review under responsibility of Chongqing Medical University or college.. developed countries.1, 2 Japan records the highest incidence of KD in the world with an incidence of 308.0/1,00,000 children less than 5 years in 2014.3 The incidence of KD in Korea and Taiwan is 194.7 and 69.5/1,00,000 children below 5, respectively.4, 5 Reliable nationwide data are not available for India and China. Hospital based data from Chandigarh suggest that the incidence of KD has been found to be increasing every year.6 Similar styles on incidence of KD are discernible in several cities from China.7, 8 Involvement of coronary arteries is a hallmark complication of KD and this may develop in approximately 15C25% of untreated patients. The risk of coronary artery complications is even higher in infants with KD and it may be as Linifanib (ABT-869) high as 60%. Approximately 3C5% may develop coronary artery abnormalities even after administration of IVIg.1 Thrombocytosis has consistently been reported in patients with KD and is often seen in 2nd to 3rd week of the illness.1, 2, Linifanib (ABT-869) 9 It was initially thought to be a benign and reactive phenomenon secondary to underlying inflammation. However, recent knowledge about platelet biology (Table 1) has suggested that platelets are not only increasing in number but they are activated as well, thereby increasing the risk of thrombosis.10, 11, 12, 13 Thrombocytopenia has also been found in acute phase of KD14 and has Linifanib (ABT-869) been documented to be a risk factor for CAAs.15, 16, 17, 18, 19, 20 In this evaluate, we update on the current best understanding about pathogenic role of elevated platelets in patients with?KD. Table 1 Studies on platelets activation and CAA physiology in Kawasaki disease. thead th rowspan=”1″ colspan=”1″ S. no. /th th rowspan=”1″ colspan=”1″ Author, year and reference /th th rowspan=”1″ colspan=”1″ Conclusion from study /th /thead 1Yokoyama et?al (1980)38Thrombocytosis in children of KD with CAAs increases the risk for thrombosis due to hyperaggregability2Levin et?al (1985)21Thrombocytosis in KD is associated with appearance of a circulatory factor that induces aggregation and serotonin release from platelets. br / Platelet derived vasoactive mediators may increase vascular permeability and facilitate further deposition of immune complexes in the tissues.3Hamaoka et?al (1996)33CAAs associated with KD significantly decrease coronary flow velocity and have abnormal flow profile with reduced coronary circulation reserve.4Straface et?al (2010)42Platelets in KD patients are activated and aggregated with numerous platelet aggregates and also show heterotypic adhesion properties with leukocytes and red blood cells.5Yahata et?al (2014)43Platelets were found to be activated during acute phase of KD. br / Aspirin led to significantly fall in PDMP levels in patients with KD. br / PDMP levels showed a rebound increase when aspirin was discontinued6Pietraforte et?al (2014)8Two different subpopulations of platelets in the peripheral blood exists i.e.annexin Linifanib (ABT-869) V positive platelets and annexinV negative platelets. br / These considerably impact inflammatory responses in KD patients.7Ueno K Rabbit Polyclonal to Cox2 et?al (2015)44Circulating platelet-neutrophil aggregates play a significant role in KD8Kim HJ et?al (2017)45PDMPs are measure of platelet activity in KD. br / PDMPs are useful as biomarker of antiplatelet therapy in KD.9Lu WH et?al (2017)47Platelet endothelial cell adhesion molecule-1 gene polymorphism was found to be associated with increased risk of coronary artery complications10Jin et?al (2018)48Increased PDMPs in patients with KD as compared to control. Rapid decrease in level of PDMPs after treatment with IVIG and aspirin. br / It was hypothesized that these platelet derived particles can directly stimulate granulocytes, macropahges, monocytes.