The clinical profile of Kawasaki disease of children from three Polish centers: a retrospective study

Abstract

Kawasaki disease (KD) is one of the most common vasculitides of childhood. The aim of this retrospective study is to determine the incidence of KD and to evaluate its presenting symptoms, clinical course, laboratory tests, and treatment in patients with complete KD and incomplete KD at three pediatric rheumatology centers in Poland from January 2011 to December 2012. A total of 27 Caucasian children (12 boys and 15 girls) with median age of 3 years (range 4 months–12 years) were included in this study. The incidence of complete versus incomplete KD was 17 (63 %) versus 10 (37 %) children, respectively. Patients with incomplete KD significantly less presented cervical lymphadenopathy (20 vs. 88.2 %; p = 0.00075), changes in extremities (30 vs. 76.5 %; p = 0.04), and bilateral nonpurulent conjunctivitis (60 vs. 100 %; p = 0.01). Cardiac assessments show that the majority of patients with KD have not got coronary artery aneurysms (CAA). The median time from the onset of symptoms to intravenous immunoglobulin (IVIG) infusion was 7 days for complete KD and 11 days for incomplete KD. IVIG delay in the incomplete KD had no effect on the incidence of CAA. In conclusion, there were no differences in demographic features, age of onset, and laboratory tests of patients with complete and incomplete KD. Patients with incomplete KD significantly rarely presented cervical lymphadenopathy, changes in extremities, and conjunctival injection. Electrocardiography is a sensitive test to recognize cardiac involvement in the acute phase of KD. Despite the fact that incomplete forms of presentation often delay diagnosis, in most patients treatment with IVIG can avoid complication of CAA.

Clinical Profile of Kawasaki Disease (KD) in Children admitted at Dhaka Shishu Hospital

“…16 Published AHA guidelines, including supplementary laboratory criteria as well as the use of echocardiography, result in better recognition of KD. 17 Regarding patients' age and sex, our study showed the similar complete and incomplete KD groups (p = 0.450 and 0.535 respectively) as compared to that with the findings of Gorczyca et al (2014). 15 However, this finding is not consistent with other previous data that suggest that incomplete KD is more common in children younger than 1 year and older than 8 years.…”

“…In the present study, out of 20 children hospitalized with KD, incomplete KD was diagnosed in 40% of cases, which is consistent with other studies. 15 However, this proportion is higher compared to the incidence (20%) reported by several other studies. 16 Published AHA guidelines, including supplementary laboratory criteria as well as the use of echocardiography, result in better recognition of KD.…”

Enfermedad de Kawasaki: Consenso interdisciplinario e intersociedades

“…Menos frecuentes son los surcos transversos en las uñas de las manos y los pies (líneas de Beau). 16,[18][19][20] …”

Kawasaki Disease: The Clinical and Cardiologic Early-Term Characteristics and Prognoses of 44 Children with Acute Attack

“…Yapılan retrospektif çalışmalarda, albumin düşüklüğü %40,8-81,5, safra kesesi hidropsu görülme oranları %4,1-12,5, steril piyüri görülme oranları ise %17-36,3 arasında değişmektedir. 11,[13][14][15]17 Hastalarımızın %86,4'ü komplet KH iken; %13,6'sına inkomplet KH tanısı konuldu. Japonya'da yapılan en son epidemiyolojik çalışmada hastaların %19,8'inde inkomplet KH olduğu bildirilmiştir.…”

“…Benzer şe-kilde, Gorczyca ve ark.nın yaptığı Avrupa kaynaklı çalışmada da komplet ve inkomplet KH grupları arasında yaş yönünden fark gözlenmemiştir. 17 Hasta sayısının az olması ve gruplara göre benzer dağılım göstermemesi nedeni ile bu sonuç elde edilmiş olabilir. Japonya, Avrupa ve Amerika Birleşik Devletleri'nde çocuklardaki edinsel kalp hastalıklarının en sık sebeplerinden biri KH'dir.…”