Chahal Nita, Somji Zeeshanefatema, Manlhiot Cedric, Clarizia Nadia A, Ashley Justin, Yeung Rae S M, McCrindle Brian W
Labatt Family Heart Centre, University of Toronto, The Hospital for Sick Children, Toronto, Canada.
Pediatr Int. 2012 Jun;54(3):383-7. doi: 10.1111/j.1442-200X.2012.03628.x.
Previous studies on recurrence of Kawasaki disease (KD) have mostly been limited to Japan, which has an incidence of KD 8-10-fold higher than North America. The aim of the present study was to determine the rate of KD recurrence for patients in Ontario, to identify factors potentially associated with increased odds of recurrence, and to compare the clinical course and outcomes of index and recurrent KD episodes.
Review was undertaken of all patients with recurrence of KD identified in Ontario, Canada, from 1995 to 2006. All patients with recurrence of KD (defined as at least three clinical signs of KD in addition to fever ≥ 5 days), presenting ≥ 14 days after the return to baseline from the index episode were included.
A total of 1010 patients were followed for 5786 patient-years. During this period a total of 17 recurrent episodes in 16 patients were identified at a median of 1.5 years after the initial episode (2 weeks-5 years). Rate of recurrence of KD was 2.9 episodes/1000 patient-years, which is higher than the expected annual incidence of KD in the same age group (26.2/100,000 per year). No factors associated with increased risk of recurrence were identified, perhaps due to the small number of events. Clinical course and outcomes of the index and recurrent KD episodes were similar.
A previous history of KD should increase the index of suspicion for future episodes of KD to allow for rapid recognition, treatment and to achieve optimal outcomes.
以往关于川崎病（KD）复发的研究大多局限于日本，该国KD发病率比北美高8至10倍。本研究的目的是确定安大略省患者的KD复发率，识别可能与复发几率增加相关的因素，并比较初发和复发KD发作的临床过程及结局。
对1995年至2006年在加拿大安大略省确诊为KD复发的所有患者进行回顾。纳入所有KD复发患者（定义为除发热≥5天外，至少有三项KD临床体征），且在初发事件恢复至基线后≥14天出现症状。
共对1010例患者进行了5786患者年的随访。在此期间，共确定16例患者出现17次复发事件，中位时间为初次发作后1.5年（2周 - 5年）。KD复发率为2.9次/1000患者年，高于同年龄组KD的预期年发病率（每年26.2/100,000）。未发现与复发风险增加相关的因素，可能是由于事件数量较少。初发和复发KD发作的临床过程及结局相似。
既往有KD病史应提高对未来KD发作的怀疑指数，以便快速识别、治疗并实现最佳结局。
