Clinical analysis of Kawasaki disease complications / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the clinical features of multiple system damage in Kawasaki disease(KD) and supply large sample data to guide clinical practice.Methods Clinical records of 1 370 patients with acute KD admitted in Children's Hospital of Chongqing Medical University from Jan.2003 to Dec.2009 were retrospectively reviewed.The complications of KD were analyzed in detail.Results Among the 1 370 KD children,881 cases were male and 489 cases were female,the male/female ratio was 1.8 ∶ 1.0.The cases under 5 years of age accounted for 88.2％ (1 209/1 370 cases).One thousand one hundred and sixty-one(84.7％,1 161/ 1 370 cases) were definite complete KD cases,209 (15.3％,209/1 370 cases) were incomplete KD cases.Except for fever,bulbar conjunctival injection was more frequent(95.6％,1 310/1 370 cases),while redness at a Bacille Calmette-Guèrin(BCG) inoculation site was less frequent(3.5％,48/1 370 cases).Of 1 370 patients with acute KD,two-dimensional echocardiography were performed in 1 348 cases.Thirty-six point one percent patients (486/1 348 cases) had occurred coronary artery lesions,27.5％ (371/1 348 cases) had coronary artery dilation only,7.6％ (102/1 348 cases) had medium coronary artery aneurysms,and 1.0％ (13/1 348 cases) had giant coronary artery aneurysms.Sinus tachycardia was most common (42.9％,166/378 cases) in the electrocardiographic abnormalities of KD.Anemia(82.0％,1 122/1 369 cases) was the most frequent symptom in non-cardiovascular system complications,followed by cough and rhinorrhea (54.3 ％,744/ 1 370 cases),liver damage (47.1％,519/1 101 cases),digestive symptoms (43.5 ％,596/1 370 cases).Among the 415 patients (45.4％,415/914 cases) whose IgM antibody were positive in the pathogenic examination,Coxsackie virus infection (28.3 ％,259/914 cases) was more frequent,followed by mycoplasma pneumonia infection (4.7 ％,43/914 cases).Hepatomegaly(62.2％,217/349 cases) was the most common abnormality in the abdominal ultrasound examination.Increased lung markings (26.0％,110/423 cases) and interstitial pneumonia (25.1％,106/423 cases) were more frequent in the chest X-ray examination.Conclusions KD can cause multiple system damages.In addition to coronary artery lesions,physicians should pay more attention on the non-cardiovascular complications.