Changes of clinical characteristics and outcomes in patients with Kawasaki disease over the past 7 years in a single center study / 소아과

PURPOSE: This single-center study was conducted to assess the changes in epidemiological and clinical characteristics and outcomes of patients with Kawasaki disease (KD) over the past 7 years. METHODS: This retrospective study included 135 children with KD, admitted to Chungnam National University Hospital, Daejeon, between 2004 and 2005 (group A, n=53) and between 2011 and 2012 (group B, n=82). Medical records were reviewed to obtain information regarding the presenting signs and symptoms, demographic characteristics, and laboratory and echocardiographic findings associated with KD. RESULTS: The hospital admission date after onset was significantly earlier in group B than in group A (P=0.008). The proportion of patients with incomplete KD was 45.3% and 65.9% in group A and B, respectively (P=0.018). The number of pretreatment coronary artery lesions (CALs) were significantly lesser in group B than in group A. (10/53 vs. 5/82, P=0.021). No significant differences was observed in the incidence of CALs at discharge, febrile phase duration, hospital stay duration, incidence of retreatment, and intravenous immunoglobulin dose between 2 groups. The total febrile phase was shorter in patients with incomplete KD than in those with complete KD in both groups. CONCLUSION: The proportion of incomplete KD has become higher. Furthermore, early admission and management of patients with KD may be related to increased incomplete KD and decreased CALs. Therefore, we believe that a diagnostic strategy for incomplete KD should be established regardless of the presence of coronary lesions.

Clinical and radiologic evaluation of cytomegalovirus-induced thrombocytopenia in infants between 1 and 6 months of age

BACKGROUND: Up to 90% of neonates with congenital or perinatal cytomegalovirus (CMV) infection are asymptomatic, and little is known about CMV-associated thrombocytopenia after the neonatal period. We investigated the clinical findings of a series of infants diagnosed with CMV infection and thrombocytopenia. METHODS: From July 2005 to July 2008, infants aged younger than 6 months with thrombocytopenia were screened for CMV infection, using CMV IgM. Those who were positive for CMV IgM were then tested for CMV IgG via polymerase chain reaction (PCR) for CMV and CMV pp65 Ag and urine culture. Brain magnetic resonance imaging (MRI) and otologic and ophthalmologic evaluations were also performed. RESULTS: Twenty-one patients aged between 1 and 6 months (11 boys and 10 girls) were admitted and tested for CMV infection. Six patients (28.6%) were positive for CMV IgM; these were also positive for CMV IgG, CMV PCR, and urine culture, and 4 were also positive for CMV pp65 Ag. The median platelet count at admission was 6,500/microliter (range, 2,000-105,000/microliter). One patient (16.7%) was diagnosed with Evans syndrome and had calcifications on brain MRI. One patient had unilateral sensorineural hearing loss. CONCLUSION: Thrombocytopenia can be the main clinical manifestation of otherwise asymptomatic CMV infection after the neonatal period, and close follow-up of neurodevelopmental sequelae is needed.

Speech Delay of Children with Mental Retardation / 대한소아신경학회지

PURPOSE:The purposes of this paper are to analyse the degree of language delay according to the classification and the etiology of mental retardation and to assess the efficacy of language treatment in children who received language treatment. METHODS:The number of the subjects for the research is 79. The subjects had been diagnosed as children of mental retardation after a language development test from the language treatment center of the Chungnam National University Hospital from January, 2003 to December, 2007. We gathered the data concerning their main complaints, their etiology of mental retardation, their results of a language development test and an intelligence test, and their results of language treatment. RESULTS:The results of our analysis to the data are as follows: The distribution of mental retardation classified as mild, moderate, and severe is 51.9% of the subjects, 27.9% and 20.2% each. The etiology of mental retardation is distributed as postnatal(20.3%), prenatal(13.9%), prenatal(5.1%), and idiopathic(60.7%). According to the classification of mental retardation, receptive, expressive, and synthetic language show a significant difference. There is no significant difference in the etiology of mental retardation in statistics. Among 28 children taken a language test after language treatment, 14 mild mental retarded children made their language delay to be shortened by 19.9 months, 10 moderate mental retarded children made their language delay to be shortened by 7.2 months, and 4 severe mental retarded children reduced their language delay by 1.3 month. CONCLUSION:The more severe mental retardation is, the longer language delay occurred. But there is no significant difference to language delay according to the etiology of mental retardation. After language treatment, mild mental retarded children show the remarkable shortening of language delay, while moderate and severe mental retarded children are slightly shortening. Therefore, it is thought that more active language treatment is needed to mild mental retarded children.