A 10-year cross-sectional retrospective study on Kawasaki disease in Iranian children: incidence, clinical manifestations, complications, and treatment patterns

BMC Infectious Diseases

Anahita Izadi¹  Mohsen Jafari¹  Effat Hosseinali Beigi²  Azadeh Afshin³  Sayed Yousef Mojtahedi³  Payman Sadeghi⁴  Pourya Yarahmadi⁵  Leila Khedmat⁶ 

[1] Department of Pediatric Infection Disease, Tehran University of Medical Sciences, Tehran, Iran;Department of Pediatric Intensive Care Unit, Bahrami Children Hospital, Tehran University of Medical Science, Tehran, Iran;Department of Pediatric Nephrology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran;Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Shahid Kiaee Street (Ghasem Abad), Damavand Street, 1641744991, Tehran, Iran;Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran;Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran;

关键词: Kawasaki disease;    Children;    Coronary artery abnormality;    Gastrointestinal complication;    Intravenous immunoglobulin;    Clinical marker;   

DOI  :  10.1186/s12879-021-06046-2

来源: Springer

【 摘 要 】

BackgroundKawasaki disease (KD) as an acute, systemic vasculitis is the leading cause of acquired heart disease in children under the age of 5 years.MethodsA 10-year cross-sectional retrospective study was designed to assess 190 Iranian children with KD during 2008–2018. Demographic data, clinical and laboratory manifestations from the onset of symptoms to diagnosis, clinical signs and symptoms, and subsequent treatments were evaluated to predict hospitalization stay, complications, and response to treatment.ResultsChildren with KD had a male-to-female ratio of 1.18:1 and an average age of 36 months. There was an insignificantly more incidence of KD in cold seasons. The most frequent symptoms were fever (92.6%), oral mucus membrane changes (75.8%), bilateral bulbar conjunctival injection (73.7%), polymorphous skin rash (73.2%), peripheral extremity changes (63.7%), and cervical lymphadenopathy (60.0%). The rate of gastrointestinal, cardiac, joint, and hepatic complications was determined to be 38.4, 27.9, 6.8, and 4.2%, respectively. 89.5% of patients received intravenous immunoglobulin (IVIG) plus aspirin as the first line of treatment, while, 16.3% of them needed an extra second line of treatment. Significantly low serum sodium levels and high platelet counts were detected in KD patients with cardiac complications. Cardiac complications often were more encountered in patients who did not respond to the first line of treatment. Higher platelet count, lower serum sodium amount, and C-reactive protein (CRP) level were significantly associated with a need for an additive second line of treatment. A significant relationship between hospitalization stay and hemoglobin level was found.ConclusionAs most of the clinical manifestations and complications were following other reports released over the past few years, such data can be confidently used to diagnose KD in Iran. Seasonal incidence and a positive history of recent infection in a notable number of patients may provide clues to understand possible etiologies of KD. Laboratory markers can successfully contribute to health practitioners with the clinical judgment of the need for additional treatments, possible complications, and hospitalization duration.

【 授权许可】

CC BY