Enfermedad de Kawasaki en 76 pacientes. Factores de riesgo de aparición de aneurismas coronarios

Riesgo de afectación coronaria en la enfermedad de Kawasaki

“…Hasta un 15%-25% de los pacientes no tratados presentan AC, lo que disminuye a menos de un 5% en los pacientes que reciben tratamiento con gammaglobulina antes del décimo día de enfermedad. 1,3 Actualmente, la EK se considera la principal causa de cardiopatía adquirida en la infancia en los países desarrollados. 3,4 La forma de presentación incompleta de la EK se ha relacionado con un mayor retraso en el diagnóstico y en el inicio del tratamiento, que, a su vez, podrían ocasionar un mayor riesgo de AC.…”

“…1,3 Actualmente, la EK se considera la principal causa de cardiopatía adquirida en la infancia en los países desarrollados. 3,4 La forma de presentación incompleta de la EK se ha relacionado con un mayor retraso en el diagnóstico y en el inicio del tratamiento, que, a su vez, podrían ocasionar un mayor riesgo de AC. 5,6 El objetivo de este estudio es identificar los factores de riesgo asociados a la afectación coronaria en pacientes con EK completa e incompleta.…”

Risk of coronary artery involvement in Kawasaki disease

“…7 Complete KD diagnostic criteria were fever persisting at least 5 days and the presence of at least 4 of the following 5 criteria: (1) changes in limbs: erythema of the palms and soles or swelling of the hand and feet in the acute phase and/or fingers and toes periungual desquamation in the subacute phase; (2) polymorphous exanthema; (3) bilateral nonexudative conjunctival injection; (4) changes in lips and oral cavity: erythema and cracking of lips, strawberry tongue and pharyngeal hyperemia; (5) cervical lymph node enlargement (>1.5 cm in diameter), excluding other diseases with similar clinical features. Incomplete KD diagnostic criteria were the following: 7 fever of, at least, 5 days long and the presence of 2 or 3 of the previously mentioned clinical criteria of the disease, together with C-reactive protein (CRP) ≥3 mg/dL and/or erythrocyte sedimentation rate (ESR) ≥40 mm/h and, at least, 3 of the following analytical abnormalities: albumin ≤3 g/dL, anemia for the age, increased level of the glutamic pyruvic transaminase (GPT), platelet level after day 7 ≥450 000/mm 3 , total leukocytes ≥15 000/mm 3 and pyuria ≥10 leukocytes/high power field. The first day of the disease was defined as the first day with a body temperature ≥38 °C.…”

“…Such percentage decreases to less than 5% in patients receiving gammaglobulin treatment before day 10 of the disease. 1,3 Currently, KD is considered the main cause of acquired heart disease during childhood in developed countries. 3,4 Incomplete KD has been related to a greater delay in diagnosis and treatment onset, which, in turn, could result in a higher CAD risk.…”

“…1,3 Currently, KD is considered the main cause of acquired heart disease during childhood in developed countries. 3,4 Incomplete KD has been related to a greater delay in diagnosis and treatment onset, which, in turn, could result in a higher CAD risk. 5,6 Our objective is to identify risk factors associated with coronary artery disease in patients with complete and incomplete KD.…”