From the Allergy Immunology Unit and the Division of Pediatric Biochemistry, Advanced Pediatrics Centre, and.
Department of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
J Clin Rheumatol. 2018 Oct;24(7):385-389. doi: 10.1097/RHU.0000000000000754.
Kawasaki disease (KD) has a predilection to involve coronary arteries, leading to several long-term cardiovascular sequelae. Apart from coronary artery abnormalities, children with KD are also prone to develop premature atherosclerosis, endothelial dysfunction, and lipid abnormalities. Some of these complications may occur even in children who have received appropriate treatment with intravenous immunoglobulin in the acute phase.
In 2009, we had studied carotid intima-media thickness (cIMT) and lipid profile in 27 children with KD at least 1 year after the acute episode. In the present study, we have followed up the same cohort of 27 children at least 5 years after the acute episode of KD. We measured the cIMT, a surrogate marker for premature atherosclerosis, and fasting lipid profile in the cohort and compared the results with values obtained in our previous study.
There was significantly higher mean cIMT in children with KD as compared with control subjects. However, there was no significant difference in cIMT among children in the cohort at 1 and 5 years of follow-up. Abnormal lipid profile was seen in 7 of 27 children in the present study, 5 of whom also had had lipid abnormality at 1-year follow-up. This suggests that lipid abnormalities in KD may be long lasting.
Children with KD need careful long-term follow-up even when they do not have overt and persistent coronary artery abnormalities. It is possible that consequences of KD in childhood may impact health status of young adults several years later.
川崎病（KD）易累及冠状动脉，导致多种长期心血管后遗症。除冠状动脉异常外，KD 患儿还易发生早发动脉粥样硬化、内皮功能障碍和血脂异常。这些并发症中的一些甚至可能发生在急性期接受静脉注射免疫球蛋白适当治疗的儿童中。
2009 年，我们研究了 27 例 KD 患儿在急性发作后至少 1 年的颈动脉内膜中层厚度（cIMT）和血脂谱。在本研究中，我们对 KD 急性发作后至少 5 年的同一队列进行了随访。我们测量了 cIMT，这是动脉粥样硬化早发的替代标志物，并比较了队列中的空腹血脂谱与我们之前研究中的结果。
KD 患儿的平均 cIMT 明显高于对照组。然而，在 1 年和 5 年的随访中，队列中儿童的 cIMT 没有显著差异。本研究中 27 例儿童中有 7 例血脂异常，其中 5 例在 1 年随访时也存在血脂异常。这表明 KD 中的血脂异常可能是长期存在的。
即使 KD 患儿没有明显和持续的冠状动脉异常，也需要进行仔细的长期随访。KD 在儿童时期的后果可能会对数年后面临的年轻成年人的健康状况产生影响。
