Service de Pédiatrie Générale, Rhumatologie Pédiatrique, Centre de Références des Maladies Auto-Inflammatoires, CHU de Bicêtre, Assistance publique-Hôpitaux de Paris, 94270 Le Kremlin Bicêtre, France.
Joint Bone Spine. 2009 Oct;76(5):481-5. doi: 10.1016/j.jbspin.2008.11.015. Epub 2009 Oct 6.
To compare the clinical and laboratory features and the rate of echocardiographic coronary artery abnormalities in patients with complete and incomplete forms of Kawasaki disease (KD) and to determine which additional clinical criteria might support a suspicion of KD.
We retrospectively reviewed the medical records of patients with KD who were admitted to the general pediatrics department of the Kremlin Bicêtre Teaching Hospital, France, between January 1995 and May 2006. We compared patients with a fever and four or five of the principal criteria (complete KD) to the other patients (incomplete KD). Clinical and laboratory features were abstracted from the records.
We identified 63 patients with a mean age of 33 months (+/-31). The male-to-female ratio was 2.47. Four patients were excluded. Of the remaining 59 patients, 39 had complete KD and 20 incomplete KD. The group with complete KD had significantly higher rates of changes in the extremities, conjunctival injection, exanthem, and enanthem; and a significantly lower rate of coronary artery dilation (48.7% vs. 90% in the incomplete KD group, P=0.002). Serum levels of alanine aminotransferase and gamma glutamyl transferase were significantly higher in the complete KD group. No significant differences were found between the two groups regarding age, sex, blood cell counts, or laboratory markers for inflammation. Pyuria was found in 45.4% of patients with complete KD and in 30.8% of those with incomplete KD (P=0.17). Of 14 patients who underwent ophthalmological evaluation, two had uveitis; both of them had complete KD.
Incomplete KD shares with complete KD a risk of coronary artery disease. The diagnosis of incomplete KD is challenging but can be supported by the presence of features other than the principal criteria, such as acute anterior uveitis or unexplained pyuria.
比较完全型和不完全型川崎病（KD）患者的临床和实验室特征及超声心动图冠状动脉异常发生率，并确定哪些附加临床标准可能有助于提示 KD。
我们回顾性分析了 1995 年 1 月至 2006 年 5 月期间在法国克里姆林比塞特尔教学医院儿科普通病房住院的 KD 患者的病历。我们将发热且符合四项或五项主要标准（完全型 KD）的患者与其他患者（不完全型 KD）进行了比较。从病历中提取了临床和实验室特征。
我们共纳入了 63 例患者，平均年龄为 33 个月（+/-31）。男女性别比为 2.47。有 4 例患者被排除。在剩余的 59 例患者中，39 例为完全型 KD，20 例为不完全型 KD。完全型 KD 组的四肢变化、结膜充血、皮疹和口腔黏膜改变发生率明显更高，而冠状动脉扩张的发生率明显更低（48.7%对不完全型 KD 组的 90%，P=0.002）。完全型 KD 组的血清丙氨酸氨基转移酶和γ-谷氨酰转移酶水平明显更高。两组患者在年龄、性别、血细胞计数或炎症标志物方面无显著差异。完全型 KD 组中 45.4%的患者有脓尿，而不完全型 KD 组中这一比例为 30.8%（P=0.17）。在接受眼科评估的 14 例患者中，有 2 例患有前葡萄膜炎，均为完全型 KD。
不完全型 KD 与完全型 KD 一样存在发生冠状动脉疾病的风险。不完全型 KD 的诊断具有挑战性，但存在主要标准以外的特征（如急性前葡萄膜炎或不明原因的脓尿）可支持其诊断。
