Soriano-Ramos María, Martínez-Del Val Elena, Negreira Cepeda Sagrario, González-Tomé María I, Cedena Romero Pilar, Fernández-Cooke Elisa, Albert de la Torre Leticia, Blázquez-Gamero Daniel
Servicio de Pediatría, Fundación para la Investigación Biomédica, Hospital 12 de Octubre, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, 28041 España.
Arch Argent Pediatr. 2016 Apr;114(2):107-13. doi: 10.5546/aap.2016.eng.107. Epub 2016 Feb 5.
Kawasaki disease refers to systemic vasculitis with risk of coronary artery disease. Our objective is to identify risk factors associated with coronary artery disease in patients with complete and incomplete Kawasaki disease.
Descriptive, retrospective study conducted in patients diagnosed with Kawasaki disease in a tertiary-care hospital between 2008 and 2014. The American Heart Association diagnostic criteria were used to define complete and incomplete Kawasaki disease.
Thirty-one children were diagnosed with Kawasaki disease; 24 met the criteria for the complete form, and 7, for the incomplete form of this condition. Five had coronary artery disease. One of them had incomplete Kawasaki disease (1/7= 14.3%), and the remaining four had the complete form (4/24= 16.7%). No significant differences were found between both groups (p= 1.0). Patients with coronary artery involvement had a higher C-reactive protein level (median: 16.2 mg/dL versus 8.4 mg/dL, p= 0.047) and lower albuminemia (median: 3.2 mg/dL versus 3.99 mg/dL, p= 0.002).
The risk of coronary artery involvement in incomplete Kawasaki disease is similar to that in complete Kawasaki disease; therefore, in patients with the incomplete form, immunoglobulin therapy should not be delayed. In our population, C-reactive protein and albumin levels were related to a higher risk of coronary artery involvement.
川崎病是一种伴有冠状动脉疾病风险的系统性血管炎。我们的目的是确定完全型和不完全型川崎病患者中与冠状动脉疾病相关的危险因素。
对2008年至2014年在一家三级医疗中心诊断为川崎病的患者进行描述性回顾性研究。采用美国心脏协会诊断标准定义完全型和不完全型川崎病。
31名儿童被诊断为川崎病;24名符合完全型标准,7名符合不完全型标准。5名患有冠状动脉疾病。其中1名患有不完全型川崎病(1/7 = 14.3%),其余4名患有完全型川崎病(4/24 = 16.7%)。两组之间未发现显著差异(p = 1.0)。冠状动脉受累患者的C反应蛋白水平较高(中位数:16.2mg/dL对8.4mg/dL,p = 0.047),白蛋白血症较低(中位数:3.2mg/dL对3.99mg/dL,p = 0.002)。
不完全型川崎病患者冠状动脉受累的风险与完全型川崎病相似;因此,对于不完全型患者,不应延迟免疫球蛋白治疗。在我们的研究人群中,C反应蛋白和白蛋白水平与冠状动脉受累的较高风险相关。