Garrido-García Luis Martín, Castillo-Moguel Ariel, Vázquez-Rivera Mirella, Cravioto Patricia, Fernando Galván
From the *Cardiology Department, †Department of Paediatrics, and ‡Teaching Department, Instituto Nacional de Pediatria, Mexico City, Mexico.
Pediatr Infect Dis J. 2017 Oct;36(10):e237-e241. doi: 10.1097/INF.0000000000001633.
Kawasaki disease (KD) is an acute self-limited systemic vasculitis that primarily affects children <5 years old. There is no specific diagnostic test. A reaction at the Bacille Calmette-Guérin (BCG) inoculation site has been reported as a common finding in patients with KD where BCG vaccination is mandatory. The purpose of this study was to evaluate the frequency of reactivation of the BCG in Mexican children diagnosed with KD.
A retrospective study of all patients diagnosed with KD from August 1, 1995, to August 31, 2015, at our Institution was performed. The clinical profile, laboratory results, treatment used and coronary artery abnormalities in the BCG reactive and the BCG nonreactive groups were analyzed and compared.
We included 399 patients with KD. Ninety-seven (24.3%) had BCG reaction at the inoculation site. The BCG(+) group was younger than the BCG(-) group (P < 0.000). There were 18 (18.55%) incomplete cases in the BCG(+) group compared with 65 (21.52%) in the BCG(-) group without statistical significance. The BCG+ group developed coronary artery aneurysms in 37 cases and the BCG(-) group developed coronary artery aneurysms in 111 cases without statistical significance. Multivariate analysis showed that younger age at diagnosis was the only variable associated with a reaction at the BCG inoculation site in patients with KD.
In Mexico, a country with a National BCG Vaccination Program and a low incidence of KD, reaction at the BCG inoculation site could be a useful diagnostic sign of KD.
川崎病（KD）是一种主要影响5岁以下儿童的急性自限性全身性血管炎。目前尚无特异性诊断检测方法。据报道，在强制接种卡介苗（BCG）的KD患者中，卡介苗接种部位出现反应是常见表现。本研究旨在评估墨西哥诊断为KD的儿童中卡介苗再激活的频率。
对1995年8月1日至2015年8月31日在我院诊断为KD的所有患者进行回顾性研究。分析并比较卡介苗反应组和非反应组的临床特征、实验室检查结果、治疗方法及冠状动脉异常情况。
我们纳入了399例KD患者。97例（24.3%）在接种部位出现卡介苗反应。卡介苗反应阳性（BCG(+)）组比卡介苗反应阴性（BCG(-)）组年龄更小（P < 0.000）。卡介苗反应阳性组有18例（18.55%）不完全病例，卡介苗反应阴性组有65例（21.52%），差异无统计学意义。卡介苗反应阳性组37例发生冠状动脉瘤，卡介苗反应阴性组111例发生冠状动脉瘤，差异无统计学意义。多因素分析显示，诊断时年龄较小是KD患者卡介苗接种部位出现反应的唯一相关变量。
在墨西哥这个有国家卡介苗接种计划且KD发病率较低的国家，卡介苗接种部位的反应可能是KD的一个有用诊断体征。
