Results: 15 patients were included: 11 women and 4 men, with a mean age of 42.2 years (SD+/-16) The genetic study was performed in 12 patients: 75% were positive for HLA DQ2 and 25% for HLA DQ8. The determination of antibodies was positive in 12 patients (73%) and negative in 3 (27%). These 3 were positive for the genetic study (2 HLA DQ2 and 1 HLA DQ8). The study of BD showed: type I in 4 patients; Type IIIa in 2 patients; Type IIIb in 6 patients; Type IIIC in 3 patients. BMD showed normal values in 33%, osteopenia in 47% and osteoporosis (OP) in 20% of patients. Thus, 67% had an alteration in BMD at the time of diagnosis. 100% had a Vit D deficit, with a mean value of 14.3 ng/mL (range 4.15-26.8). 75% of them had values below 20 ng/mL (40% less than 10 ng/mL). 40% had secondary hyperparathyroidism (SHP), 83% of which had an alteration in BMD (67% osteopenia and 16% OP). The BD of the patients with SHP and alteration of the BMD showed a histological pattern type Marsh III. No patient presented an alteration in the values of calcemia, phosphataemia or calciuria. The relationship between the degree of alteration in BMD and the Marsh classification (table) was studied. 72% of patients with a Marsh III had an alteration in BMD (3 OP and 5 osteopenia vs 3 normal).
BackgroundKawasaki disease (KD) is a systemic vasculitis characterized by acute and prolonged fever. The prevalence of coronary artery abnormality (CAA) is as high as 11%. The young infants usually have the increased risk of CAA, but do not have the typical clinical manefestations of KD.ObjectivesTo explore clinical features of children with KD in different age groups to improve the prognosis of KD.MethodsA total of 218 children with kawasaki disease were divided into the infants group, the toddlers' group, the pre-school age group and the school age group. Retrospective analysis of clinical data were performed among the groups. Categorical data were compared with each other statistically by Chi-square analysis. Statistical significant was defined as P <0.05. Due to the insufficient cases of school age group and five cases of patients with entire clinical data, the analysis was focused on the other three groups and excluded the five cases in the following statistical analysis.Results(1) Among the 218 KD patients, the male to female ratio was 1.5:1 and the recurrence rate was 1.8%. Seven cases (3.2%) were diagnosed as atypical KD, and 84 (38.5%) patients accepted intravenous gamma globulin (IVIG) treatment after the sixth day of KD onset. The incidence of IVIG-resistent KD was 8.7% and the rate of coronary dilation was 11.5%. (2) Fever was the most common clinical feature (100%). The bilateral bulbar conjunctiva injection and the change in mucosa of oropharynx were 85.4% and 81.2% respectively. Moreover, cough (40.5%), diarrhea (16.9%) and vomiting (8.5%) were also very common in the present KD patients. (3) Patients from the toddlers' group were more common to develop lymphadenopathy and skin rash (χ2=7.784, P=0.02; χ2=10.794, P=0.005), but were less frequently to be documented with cough and diarrhea (χ2=7.334, P=0.026; χ2=18.447, P=0.000). (4) The incidence of increased platelets was more common in the infants group (χ2=7.552, P=0.023). Comparing with the urine test among three groups, the toddlers' group had a higher incidence of sterile pyuria (χ2=10.653, P=0.005), and infants younger than 12 months old had a lower incidence of proteinuria and positive urine ketone (χ2=15.507, P=0.000; χ2=40.336, P=0.000).ConclusionsThe respiratory tract, the digestive and urinary systems are involved commonly in Kawasaki disease, and patients from different age groups showed different clinical features, which should be pay more attention to promote the prognosis.References Kowalczyk M,Turska-Kmiec A,Ziolkowska L,et al. [Symptoms, diagnosis and characteristic abnormalities in the coronary arteries in Kawasaki disease in children]. Med Wieku Rozwoj, 2010. 14(4):344–349.Burns JC,Shike H,Gordon JB,et al. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol, 1996. 28(1):253–257.Newburger JW,Takahashi M,Gerber MA,et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council o...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.