Atypical Kawasaki disease

Ristovski, Ljiljana; Milankov, Olgica; Vislavski, Melanija; Savic, Radojica; Bjelica, Milena

doi:10.2298/mpns1602053r

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Furthermore, atypical KD is characterized by a fever for a minimum of five days and the presence of two or three of the above criteria. The diagnosis of atypical KD is based on echocardiographic findings indicating the involvement of the coronary arteries [5,6,7] and the laboratory markers. McCrindle et al [7] suggested diagnostic pathways for suspected atypical patients with respect to the laboratory findings (white blood cell, WBC) count of ≥15,000 mm 3 , platelet count of ≥450,000 mm 3 , pyuria of ≥10 WBC/high-power field (HPF), albumin level of ≤3 g/dL, elevation of alanine aminotransferase (ALT) and anemia for age).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Symptoms and Cardiac Lesions in Children with Typical and Atypical Kawasaki Disease

2019

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The present study was performed to evaluate the clinical symptoms and cardiovascular complications in patients with typical and atypical Kawasaki disease (KD). This retrospective study was conducted on the medical records of 176 patients with KD for three years. The study population was divided into two groups of typical and atypical based on the KD clinical criteria. The two groups were compared in terms of demographic data, clinical symptoms, cardiac lesions, and laboratory markers. Based on the diagnostic criteria, 105 (60%) and 71 (40%) patients were diagnosed with typical and atypical KD, respectively. The mean age of the typical patients (38.16 months) was higher than that of the atypical group (24.03 months) at the time of diagnosis (p < 0.05). The results revealed no significant difference between the two groups regarding the seasonal distribution of KD onset (p = 0.422). However, the most common season for the diagnosis of the disease was spring, followed by winter. There was no significant difference between the two groups in terms of fever duration (p = 0.39). Furthermore, vomiting was more common in the atypical patients than in the typical group (p = 0.017). In terms of the cardiac lesions, ectasia (p = 0.005) and lack of tapering of the distal coronary vessels (p = 0.015) were more frequently detected in the atypical group than in the typical group. Considering the laboratory findings, thrombocytosis (p = 0.010) and anemia (p = 0.048) were more common in the atypical group, compared to those in the typical group. On the other hand, the typical group had a higher serum alanine aminotransferase level (adjusted for age) (p = 0.012) and Hyponatremia (serum sodium concentration ≤130 mmol/L) (p = 0.034). Based on the findings of the current study, the fever duration from onset to diagnosis was slightly more in atypical KD patients than in the typical group, but not statistically significant, possibly due to more timely diagnosis of atypical KD. There was no difference in coronary aneurysm between the two groups at the time of diagnosis. The atypical group had a higher frequency of coronary ectasia and lack of tapering, indicating cardiac involvement. Consequently, these conditions should be given more attention in the atypical patients. Furthermore, the higher frequency of anemia and thrombocytosis in the atypical patients can be useful for diagnosis of this kind of KD.

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Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Symptoms and Cardiac Lesions in Children with Typical and Atypical Kawasaki Disease

2019

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“…A doença de Kawasaki pode acarretar em diversas complicações para os pacientes, variando desde desordens cardiovasculares -como aneurisma de artéria coronária, infarto do miocárdio, aneurismas e ectasiasa complicações gastrointestinais, como obstrução intestinal, edema de cólon, isquemia intestinal; e neurológicas, dentre as quais podem ser citadas meningoencefalite, coleção subdural, hipoperfusão cerebral dentre outras (ALVES et al, 2011;RISTOVSKI et al, 2016;RODRIGUES et al, 2018). A complicação mais grave, no entanto, é a vasculite coronariana, a qual afeta de 15% a 20% dos pacientes não tratados.…”

Section: Discussionunclassified

Relato de caso: doença de Kawasaki atípica em criança de oito meses / Case report: atypical Kawasaki disease in an eight-month child

Hahmann¹,

Folini²

2021

BJDV

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A Síndrome MucocutâneaLinfonodal ou doença de Kawasaki (DK) é uma vasculite sistêmica que acomete preferencialmente vasos de pequeno e médio calibre. É uma condição clínica sem agente etiológico conhecido e que apresenta variada epidemiologia ao redor do mundo. A incidência é mais elevada em crianças menores de cinco anos de idade, sendo que crianças do sexo masculino apresentam maior probabilidade de desenvolver a patologia. Suas manifestações clínicas incluem principalmente: febre persistente por mais de cinco dias, conjuntivite não exsudativa, alterações mucocutâneas e linfadenopatia cervical. A doença apresenta três fases: a aguda, a subaguda e o período de recuperação; além disso, pode ser classificada em completa ou incompleta, ou atípica. As complicações decorrem principalmente da demora ou erro diagnóstico e apresentam grande gravidade e severidade, sendo que a mais grave delas é a coronariopatia, podendo afetar não somente o sistema cardiovascular, mas também o sistema gastrointestinal e neurológico. As medidas terapêuticas incluem ácido acetilsalicílico e imunoglobulina intravenosa. Dessa forma, o presente relato busca apresentar um caso de doença de Kawasaki incompleta com os principais achados clínicos e laboratoriais presentes a fim de auxiliar os médicos na realização de raciocínio clínico que a considere como hipótese diagnóstica quando diante de quadro semelhante.

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