Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea.
Korean Circ J. 2011 Jul;41(7):394-8. doi: 10.4070/kcj.2011.41.7.394. Epub 2011 Jul 30.
In addition to diagnostic criteria, a broad range of nonspecific clinical features can be found in patients with Kawasaki disease. This lack of specificity may cause confusion with other febrile illnesses and delay the diagnosis of Kawasaki disease. The purpose of this study is to describe common associated symptoms and their clinical significances in children affected with Kawasaki disease.
As a retrospective study, we reviewed the medical records of 121 children who were treated for Kawasaki disease at Presbyterian medical center from January 2005 to June 2010. All clinical symptoms, laboratory data and echocardiographic findings in patients with KD were collected and analyzed.
We found that there are 9 associated symptoms, namely cough, rhinorrhea, sputum, abdominal pain, vomiting, diarrhea, arthralgia, headache and seizure, which occur in patients with Kawasaki disease. Among the study group, there were only 32 children with no associated symptoms (26.4%). Patients with abdominal pain and headache had an older mean age than those without such symptoms. The incidence of seizure was significantly higher in incomplete Kawasaki disease patients compared with those with complete Kawasaki disease. Vomiting was highly associated with IVIG non-responder group.
To decrease the incidence of serious coronary complications due to delayed diagnosis, physicians need to be aware of the manifestations of Kawasaki disease and the possibility of associated symptoms, which, being unspecific, may otherwise not raise any red flags.
除了诊断标准外,川崎病患者还可能出现广泛的非特异性临床特征。这种缺乏特异性可能会导致与其他发热性疾病混淆,并延误川崎病的诊断。本研究的目的是描述患有川崎病的儿童常见的相关症状及其临床意义。
作为一项回顾性研究,我们查阅了 2005 年 1 月至 2010 年 6 月在长老会医疗中心接受川崎病治疗的 121 名儿童的病历。收集并分析了 KD 患者的所有临床症状、实验室数据和超声心动图结果。
我们发现川崎病患者存在 9 种相关症状,即咳嗽、流涕、咳痰、腹痛、呕吐、腹泻、关节炎、头痛和抽搐。在研究组中,仅有 32 名儿童无相关症状(26.4%)。有腹痛和头痛症状的患者比无此类症状的患者年龄更大。不完全川崎病患者的癫痫发生率明显高于完全川崎病患者。呕吐与 IVIG 无反应者高度相关。
为了降低因诊断延迟导致严重冠状动脉并发症的发生率,医生需要了解川崎病的表现和可能出现的相关症状,这些症状缺乏特异性,否则可能不会引起任何警觉。