Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Sporna 36/50 street, 91-738, Lodz, Poland.
Rheumatol Int. 2019 Jun;39(6):1069-1076. doi: 10.1007/s00296-019-04286-9. Epub 2019 Mar 22.
Kawasaki disease (KD) is an acute, self-limited, systemic vasculitis and the most common cause of acquired coronary artery disease in pediatric population in the developed countries. It occurs mostly in Asian countries; however, due to better access to diagnostic and imaging tests, it is more frequently diagnosed among pediatric patients in Poland. The aim of this study was to describe the clinical course with special interest in cardiac involvement, treatment and follow-up of Polish patients with KD. It is a single-center retrospective study. Clinical features (including coronary involvement), laboratory results and treatment were evaluated. In our study group, we observed elevated levels of indicators of inflammation: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leukocytosis, platelet count, fibrinogen, D-dimer and ferritin. We also noticed changes in lipid profile and liver enzymes. Twenty-four patients were diagnosed with coronary artery abnormalities. Mean day of treatment equaled 9th day of the disease. Kawasaki disease should be suspected in all pediatric patients who have fever lasting 5 days, or more particularly those under 5 years of age. It is very important to apply treatment within the first 10 days of disease due to the high risk of cardiovascular complications. Each child should have echocardiography on admission, around 14th day of the disease, after 4-6 weeks from the onset of symptoms, as well as long-term observation at least once a year due to the fact that the inflammatory process and changes in the lipid profile increase the risk of atherosclerosis. Children with coronary aneurysms should undergo check-ups every 6 months.
川崎病（KD）是一种急性、自限性的全身性血管炎，是发达国家儿童获得性冠状动脉疾病的最常见原因。它主要发生在亚洲国家；然而，由于能够更好地进行诊断和影像学检查，在波兰的儿科患者中，这种疾病的诊断更为频繁。本研究旨在描述波兰 KD 患者的临床过程，特别关注心脏受累、治疗和随访。这是一项单中心回顾性研究。评估了临床特征（包括冠状动脉受累）、实验室结果和治疗。在我们的研究组中，我们观察到炎症指标（红细胞沉降率[ESR]、C 反应蛋白[CRP]、白细胞增多、血小板计数、纤维蛋白原、D-二聚体和铁蛋白）升高。我们还注意到血脂谱和肝功能的变化。24 例患者被诊断为冠状动脉异常。治疗平均开始于疾病的第 9 天。对于发热持续 5 天或更长时间的所有儿科患者，特别是 5 岁以下的患者，应怀疑川崎病。由于心血管并发症的高风险，在疾病的前 10 天内进行治疗非常重要。每个孩子都应该在入院时、疾病第 14 天左右、症状出现后 4-6 周进行超声心动图检查，以及至少每年进行一次长期观察，因为炎症过程和血脂谱的变化会增加动脉粥样硬化的风险。有冠状动脉瘤的儿童应每 6 个月进行一次检查。
