Carlton-Conway Daniel, Ahluwalia Raju, Henry Lucy, Michie Colin, Wood Louise, Tulloh Robert
Department of Paediatric Cardiology, Guy's and St Thomas' Hospital Trust, Guy's Hospital, St Thomas' Street, London, SE1 9RT, UK.
BMC Pediatr. 2005 May 25;5(1):14. doi: 10.1186/1471-2431-5-14.
Kawasaki disease is a systemic vasculitis and may affect cerebral function acutely. The aim of the present study was to measure a number of behaviour and social parameters within a cohort of Kawasaki disease patients.
Parents of children with past diagnosis of Kawasaki disease were recruited to complete several behaviour screening questionnaires. Sixty five sets of questionnaires relating to the patient cohort received were eligible for inclusion. Two control groups were used, a hospital (HC) control and a sibling control (SC) group.
40% of the Kawasaki disease group showed elevated internalising scores in the clinical or borderline-clinical range. This compared with 18% of hospital controls and 13% of sibling controls. Additionally, the Kawasaki disease (KD) group were shown to be experiencing greater overall total difficulties when compared with the controls (KD 13.7, HC 8.6, SC 8.9). The KD group attained higher behavioural scores within the internalising sub-categories of somatic problems (KD 61, HC 57, SC 54) and withdrawn traits (KD 56, HC 53, SC 51). The KD group were also shown to be suffering more thought problems (KD 57, HC 53, SC 50) compared with the controls. Further difficulties relating to conduct (KD 3.3, HC 1.4) and social interactions (KD 6.7, HC 8.3) are also highlighted for the KD group compared with hospital controls. Positron emission tomograms were performed on nine patients to investigate severe behavioural problems. Three showed minor changes, possibly a resolving cerebral vasculopathy.
Kawasaki disease can be associated with significant behavioural sequelae. This is an important consideration in the long-term follow up and referral to a clinical psychologist may be necessary in selected patients.
川崎病是一种全身性血管炎，可能会急性影响脑功能。本研究的目的是测量一组川崎病患者的一些行为和社会参数。
招募过去被诊断为川崎病患儿的父母，以完成几份行为筛查问卷。收到的与患者队列相关的65套问卷符合纳入标准。使用了两个对照组，一个医院（HC）对照组和一个同胞对照组（SC）。
40%的川崎病组在临床或临界临床范围内表现出内化得分升高。相比之下，医院对照组为18%，同胞对照组为13%。此外，与对照组相比，川崎病（KD）组表现出更大的总体困难（KD 13.7，HC 8.6，SC 8.9）。KD组在内化亚类的躯体问题（KD 61，HC 57，SC 54）和退缩特质（KD 56，HC 53，SC 51）方面获得了更高的行为得分。与对照组相比，KD组还表现出更多的思维问题（KD 57，HC 53，SC 50）。与医院对照组相比，KD组在行为（KD 3.3，HC 1.4）和社交互动（KD 6.7，HC 8.3）方面也存在更多困难。对9名患者进行了正电子发射断层扫描，以调查严重的行为问题。3名患者显示有轻微变化，可能是脑部血管病变正在消退。
川崎病可能与显著的行为后遗症有关。这在长期随访中是一个重要的考虑因素，对于部分患者可能有必要转诊至临床心理学家处。
