Sensorineural hearing loss in patients with Kawasaki disease

Abstract

PurposeKawasaki disease involves acute febrile systemic vasculitis that can cause a variety of symptoms by affecting various organs. Here, we aimed to evaluate the prevalence, causes, and prognosis of sensorineural hearing loss (SNHL) occurring in children with Kawasaki disease.MethodsPatients who were diagnosed with Kawasaki disease and received inpatient treatment in the Pediatrics Department at one of three university hospitals in Daegu city from February 2012 to September 2012 were enrolled in the study. The clinical features, hematological results, echocardiography results, audiometry results, and aspirin and salicylic acid serum levels of the patients were evaluated.ResultsOf the 59 children enrolled in the study, three showed mild bilateral SNHL on audiometry tests conducted after 48 hours of defervescence; these patients demonstrated normal patterns of recovery on follow-up tests 8 weeks later. Aspirin serum levels were significantly higher in the SNHL group after 48 hours of afebrile condition with high dose aspirin intake (P=0.034). However, no significant differences were found in other laboratory tests or for fever duration (P>0.05). Upon echocardiography, coronary artery abnormality was observed in 9 cases, but none of these patients showed hearing loss.ConclusionThe results indicate that SNHL in children with Kawasaki disease might occur during treatment of the acute phase; this SNHL usually involves mild bilateral hearing loss and recovers naturally. However, this study suggests that determination of the causes and clinical implications of hearing loss in Kawasaki disease requires long-term follow-up studies with more cases.

Audio-vestibular manifestations in Kawasaki disease (KD): a rare atypical case presentation

“…This atypical finding sheds light on to the importance of KD as a progressive condition, where the SNHL can manifest in one ear and later appear with delayed onset in the other ear. Hearing loss manifested during the treatment of acute phase of KD usually involves bilateral mild sensorineural hearing loss which recovers spontaneously [27]. In the present case, it could be hypothesized that hearing loss that began as mild in one ear progressed to severe-profound in the right ear, but due to treatment effect (intravenous gamma globulin, IVIG given after KD diagnosis in the present child) the hearing would have returned to normal in the left ear.…”

Development of a reading difficulty questionnaire for adolescents in Japanese

“…KDassociated SNHL has also been associated with delayed IVIG administration, persistent thrombocytosis, anemia and elevated inflammatory markers, suggesting that a persistent systemic inflammatory process may play an important role [12]. Medication side effects, such as hearing loss related to ASA toxicity and behavioral changes from corticosteroid exposure, may further contribute [25][26][27]. There is also an emerging body of evidence suggesting that KD survivors have worse perception of their health after diagnosis, decreased physical activity and high rates of anxiety and internalizing behaviours [5,6,11].…”

The Impact of Moderate-Dose Acetylsalicylic Acid in the Reduction of Inflammatory Cytokine and Prevention of Complication in Acute Phase of Kawasaki Disease: The Benefit of Moderate-Dose Acetylsalicylic Acid

“…High-dose ASA has adverse effects, such as gastrointestinal bleeding, anemia, and sensorineural hearing loss, and is associated with a higher risk of mortality due to extremely rare but serious complications, such as Reye syndrome [ 2 , 8 , 9 , 10 ]. We observed one case of Reye syndrome in the high-dose ASA group.…”