Gorczyca Daiva, Postępski Jacek, Olesińska Edyta, Lubieniecka Małgorzata, Lachór-Motyka Iwona, Opoka-Winiarska Violetta, Gruenpeter Anna
3rd Department and Clinic of Paediatrics, Immunology and Rheumatology of Developmental Age, Wroclaw Medical University, ul. Koszarowa 5, 51-149, Wrocław, Poland,
Rheumatol Int. 2014 Jun;34(6):875-80. doi: 10.1007/s00296-013-2836-7. Epub 2013 Jul 28.
Kawasaki disease (KD) is one of the most common vasculitides of childhood. The aim of this retrospective study is to determine the incidence of KD and to evaluate its presenting symptoms, clinical course, laboratory tests, and treatment in patients with complete KD and incomplete KD at three pediatric rheumatology centers in Poland from January 2011 to December 2012. A total of 27 Caucasian children (12 boys and 15 girls) with median age of 3 years (range 4 months-12 years) were included in this study. The incidence of complete versus incomplete KD was 17 (63 %) versus 10 (37 %) children, respectively. Patients with incomplete KD significantly less presented cervical lymphadenopathy (20 vs. 88.2 %; p = 0.00075), changes in extremities (30 vs. 76.5 %; p = 0.04), and bilateral nonpurulent conjunctivitis (60 vs. 100 %; p = 0.01). Cardiac assessments show that the majority of patients with KD have not got coronary artery aneurysms (CAA). The median time from the onset of symptoms to intravenous immunoglobulin (IVIG) infusion was 7 days for complete KD and 11 days for incomplete KD. IVIG delay in the incomplete KD had no effect on the incidence of CAA. In conclusion, there were no differences in demographic features, age of onset, and laboratory tests of patients with complete and incomplete KD. Patients with incomplete KD significantly rarely presented cervical lymphadenopathy, changes in extremities, and conjunctival injection. Electrocardiography is a sensitive test to recognize cardiac involvement in the acute phase of KD. Despite the fact that incomplete forms of presentation often delay diagnosis, in most patients treatment with IVIG can avoid complication of CAA.
川崎病（KD）是儿童期最常见的血管炎之一。这项回顾性研究的目的是确定2011年1月至2012年12月期间波兰三个儿科风湿病中心完全型KD和不完全型KD患者的KD发病率，并评估其症状表现、临床病程、实验室检查及治疗情况。本研究共纳入27名白种儿童（12名男孩和15名女孩），中位年龄为3岁（范围4个月至12岁）。完全型KD与不完全型KD的发病率分别为17例（63%）和10例（37%）。不完全型KD患者出现颈部淋巴结病（20%对88.2%；p = 0.00075）、四肢变化（30%对76.5%；p = 0.04）和双侧非脓性结膜炎（60%对100%；p = 0.01）的情况明显较少。心脏评估显示，大多数KD患者未发生冠状动脉瘤（CAA）。完全型KD从症状出现到静脉注射免疫球蛋白（IVIG）的中位时间为7天，不完全型KD为11天。不完全型KD中IVIG延迟使用对CAA的发病率没有影响。总之，完全型和不完全型KD患者在人口统计学特征、发病年龄和实验室检查方面没有差异。不完全型KD患者出现颈部淋巴结病、四肢变化和结膜充血的情况明显较少。心电图是识别KD急性期心脏受累的敏感检查。尽管不完全型表现形式常常延迟诊断，但在大多数患者中，IVIG治疗可避免CAA并发症。
