期刊
RHEUMATOLOGY
卷 60, 期 4, 页码 1910-1914出版社
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keaa512
关键词
Kawasaki disease; coronary artery aneurysms; treatment; population-based study
类别
资金
- Crown Princess Lovisa's Society for Child Care
- Swedish Rheumatism Association
- Greta and Johan Kock's Foundation
- Hedberg Foundation
- Anna-Greta Crafoord Foundation
- Crafoord Foundation
- Swedish Medical Society
- Jerring Foundation
- Alfred Osterlunds Foundation
- Magnus Bergvall Foundation
- Thelma Zoega's Foundation
- Knut and Alice Wallenberg Foundation
- Medical Faculty at Lund University
- Region Skane
This study found a significantly high risk of CAA development in young children diagnosed with iKD, highlighting the importance of rapid intense treatment and vigilance in infants to reduce the frequency of CAA.
Objective. Kawasaki disease (KD) is a vasculitis of unknown aetiology with a high risk of coronary aneurysms if untreated. Timely treatment with intravenous immunoglobulin decreases the risk for coronary artery aneurysms (CAA). In this study, we set out to elucidate the factors associated with the risk of developing CAA. Methods. Records of all KD-diagnosed children in Skane between 2004 and 2014 were collected and clinical and demographic data were compiled. KD is defined according to the revised American Heart Association diagnostic criteria and classified as either complete KD (cKD) or incomplete KD (iKD). Results. KD was diagnosed in 77 children and CAA was found in 31% (n=24). Children with CAA were younger compared with children without (median; 20 vs 34months) and intravenous immunoglobulin treatment within 10days was less likely to be received (75% vs 91%). In children presenting with iKD, 47% developed CAA compared with 21% in cKD patients. Using multivariate analysis, an association between the risk of CAA with low age in children with iKD was observed. Conclusion. The risk of CAA development is disturbingly high in young children with iKD. This highlights the importance of rapid intense treatment and vigilance in infants, who are the most difficult to diagnose, in order to reduce the frequency of CAA.
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