Relationship between ocular involvement and clinical manifestations, laboratory findings, and coronary artery dilatation in Kawasaki disease

Abstract

Objectives To assess the incidence of ocular manifestations of Kawasaki disease (KD) in children and to evaluate the relationship between ocular manifestations and the other clinical manifestations, laboratory findings, and echocardiographic findings. Methods Complete ophthalmologic examination and echocardiography were performed in 36 patients with KD during the acute phase before starting the treatment. Clinical manifestations and laboratory data including white blood cell (WBC) count, neutrophil-to-lymphocyte ratio, platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were obtained from all the patients. All the clinical and laboratory findings were compared between the group with ocular involvement and the one without ocular involvement. Results The incidence of bilateral non-exudative conjunctivitis was 63.9%. It was significantly higher in patients with skin rashes ( P < 0.05). The incidence of uveitis was 36.1%, which consisted primarily of grade 1+ or 2+ acute anterior uveitis. Neutrophil count and CRP levels were significantly higher in the uveitis group than in the group without uveitis ( P < 0.05). Coronary artery dilatation showed significant correlation with uveitis ( P < 0.05). Uveitis did not show a significant correlation with other clinical manifestations, ESR, ALT level, AST level, and platelet count ( P > 0.05). Conclusion In children with Kawasaki disease, uveitis is associated with coronary artery dilatation, higher neutrophil count, and higher CRP level.

Bilateral anterior uveitis as a part of a multisystem inflammatory syndrome secondary to COVID‐19 infection

“…A 54-year-old female, with no significant past medical history, was The multisystem inflammatory syndrome that has developed the patient seems to be clinically similar to a Kawasaki-like disease which is known in pediatric population. Shiari et al 10 reported 36.1% of acute anterior uveitis in children with Kawasaki disease and found an association between uveitis and coronary artery dilatation. Another study found that the presence of anterior uveitis is helpful in the early diagnosis and treatment of incomplete Kawasaki disease and can be used as an additional diagnostic tool.…”

The role of Annexin A3 in coronary arterial lesions in children with Kawasaki disease

“…Platelets can act as the first responders in the recognition of pathogens. They rapidly generate host-defense peptides and then recruit and boost leukocytes to promote T cell-B cell crosstalk, which is necessary in adaptive immunity ( 41 – 43 ). In addition, platelets play an important role in injuring the vessel wall ( 4 , 44 ).…”

Initial anterior uveitis event associated with recent novel SARS-CoV-2 (COVID-19) infection in the setting of HLA-B27

“…Shiari et al found that approximately 36.1% of children with Kawasaki disease present with anterior uveitis. 13 A study by Esteve-Sole et al, in 2021 implicated IFN-y in the pathogenesis of multi-system inflammatory syndrome in the setting of COVID-19. 14 Although no multi-system inflammatory syndrome was present in our patient's clinical course, our team hypothesizes that the inflammatory cascade initiated by SARS-CoV-2 infection likely triggered a first event anterior uveitis associated with HLA-B27.…”