Caballero-Mora F J, Alonso-Martín B, Tamariz-Martel-Moreno A, Cano-Fernández J, Sánchez-Bayle M
Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España.
An Pediatr (Barc). 2011 Apr;74(4):232-8. doi: 10.1016/j.anpedi.2010.11.024. Epub 2011 Feb 5.
Kawasaki disease is an acute systemic vasculitis of childhood, of unknown origin, and is considered the leading cause of acquired heart disease in children. Therefore, it is important to know clinical manifestations and complications in children with Kawasaki disease in our environment and to look for risk factors for the development of cardiac complications.
Retrospective review of 76 children with Kawasaki disease evaluated from January 1997 to May 2008.
Of the patients studied, 64.5% were males. The mean age was 3 years and 4 months. The main clinical findings were fever (mean of 8.13 days), rash, bilateral non-exudative conjunctivitis, changes in lips and oral cavity, changes in the extremities, cervical lymphadenopathy and arthralgias. The most important laboratory findings were leucocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, hypoalbuminaemia, hyperbilirubinaemia, elevated serum transaminases and sterile pyuria. Twelve of the patients (15.7%) developed coronary artery aneurysms, two patients had a mild mitral insufficiency and one patient with a mild pericardial effusion. There was one case of cholestatic hepatitis. All the complications were resolved without sequelae. Male sex (OR = 1.24), an urticarial exanthem (OR = 10.53) and a C-reactive protein > 10mg/dl (OR = 4.20) were identified as risk factors for coronary aneurysms.
Our patients had the typical clinical and laboratory findings of Kawasaki disease. Mild coronary artery complications were observed in 15.7% of the patients. Male sex, an urticarial exanthem and an elevated C-reactive protein are risk factors for coronary aneurysms.
川崎病是一种病因不明的儿童急性全身性血管炎，被认为是儿童后天性心脏病的主要病因。因此，了解我们所处环境中川崎病患儿的临床表现和并发症，并寻找心脏并发症发生的危险因素非常重要。
回顾性分析1997年1月至2008年5月期间评估的76例川崎病患儿。
在研究的患者中，64.5%为男性。平均年龄为3岁4个月。主要临床发现为发热（平均8.13天）、皮疹、双侧非渗出性结膜炎、口唇和口腔变化、四肢变化、颈部淋巴结肿大和关节痛。最重要的实验室检查结果为白细胞增多、血小板增多、C反应蛋白和红细胞沉降率升高、低白蛋白血症、高胆红素血症、血清转氨酶升高和无菌性脓尿。12例患者（15.7%）发生冠状动脉瘤，2例患者有轻度二尖瓣关闭不全，1例患者有轻度心包积液。有1例胆汁淤积性肝炎。所有并发症均已治愈，无后遗症。男性（比值比=1.24）、荨麻疹样皮疹（比值比=10.53）和C反应蛋白>10mg/dl（比值比=4.20）被确定为冠状动脉瘤的危险因素。
我们的患者具有川崎病典型的临床和实验室检查结果。15.7%的患者观察到轻度冠状动脉并发症。男性、荨麻疹样皮疹和C反应蛋白升高是冠状动脉瘤的危险因素。
