Bacillus Calmette-Guerin scar reactivation (BCGitis) in Kawasaki disease. A Scoping Review
Narchi, H.; Skinner, A.
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AimTo map and synthesise the evidence on the scattered and heterogeneous reported prevalence of Bacillus Calmette-Guerin scar reactivation (BCGitis) in Kawasaki disease (KD), examine clinical associations, and identify knowledge gaps for future research. MethodsA scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, Scopus, EMBASE, Web of Science, and Cochrane Library were searched for observational studies of BCG-vaccinated children with KD. We retrieved the prevalence of BCGitis and its associations with age, sex, KD form, BCG vaccine strain, coronary artery abnormalities (CAA), and treatment response. ResultsFifteen studies from five Asian countries (Japan, Korea, Taiwan, China, Singapore), including 21,880 children with KD, were identified. The reported prevalence of BCGitis ranged from 3.5% to 75.2% (overall prevalence 40.1%, 95% CI 39.6-40.6), with a higher prevalence in younger children. It was associated with lower CAA rates (11.8% vs 13.8%) but showed no significant association with KD type, vaccine strain, or treatment response. ConclusionBCGitis is a common manifestation of KD in BCG-vaccinated children and may have diagnostic and prognostic value, particularly in younger children and those with incomplete presentations.
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