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Clinical and biochemical characteristics of Kawasaki syndrome in 22 children


Authors: H. Vyhnánková 1;  R. Vyhnánek 2;  V. Dvořáková 1;  H. Kolářová 1;  L. Vitnerová 1;  M. Magner 1;  H. Houšťková 2;  J. Zeman 1;  T. Honzík 1
Authors‘ workplace: Klinika dětského a dorostového lékařství UK 1. LF a VFN, Prahapřednosta prof. MUDr. J. Zeman, DrSc. 1;  Pediatrická klinika IPVZ a UK 1. LF, Thomayerova nemocnice, Prahapřednostka doc. MUDr. H. Houšťková, CSc. 2
Published in: Čes-slov Pediat 2014; 69 (4): 203-212.
Category: Original Papers

Overview

Kawasaki disease (KD) is an acute vasculitis. The clinical criteria for diagnosis are:
fever lasting for at least 5 days, non-purulent conjunctivitis, mucosal inflammation, cervical lymphadenopathy, skin rash and swelling and redness of the palms and soles with consecutive desquamation of the skin. Coronary arteries aneurysms and death represent the most severe complication. The incidence of KD is rising in many countries, and it is one of the most common causes of acquired heart disease in children in developed countries.

Aims:
To analyze the clinical course and laboratory findings in our group of children, and compare our findings to the literature.

Methods:
Our retrospective study included 22 children between the ages of 2 months and 8 years (32±30 months), hospitalized between January 2001 and December 2013 with KD.

Results:
Specific clinical features of KD like skin rash, conjunctivitis and mucosal inflammation were present in 91% of the children; on the other hand cervical lymphadenopathy was only present in half of the patients. Diarrhea (36.4%) was the most common nonspecific symptom. Seven children (32%) were infants under 12 months of age, among them three were younger than 6 months. 11 children got ill at the age of 1–4 years and four children were older than 5 years. Six children (27.2%), mostly infants, presented as an incomplete form of KD. Except for two children, immunoglobulins were administered on time (within 10 days of fever). Coronary abnormalities developed in one child who was not given immunoglobulins.

Conclusion:
The prognosis of children that are treated on time is good. Children under one year of age with incomplete presentation of KD remain a high-risk group, in which the diagnosis and hence the treatment could be delayed.

Key words:
Kawasaki disease, classic and incomplete form, early onset, coronary aneurysms V.


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