Shahbaznejad Leila, Hosseininasab Ali, Mahboobi Leila, Mohammadi Hamid, Esmaeili Hassan, Farrokhi Far Seyed Majid, Alipour Mohammad Reza, Sedighi Iraj, Mansour Ghanaei Roxana, Sobouti Behnam, Taremiha Alireza, Malek Abdol Reza, Ghadiri Keyghobad, Soleimani Gholamreza, Tabasizadeh Hamed, Ghadimi Moghadam Abdolkarim, Barak Manouchehr, Salehi Abarghouei Forood, Hashemian Houman, Daryani Nezhad Hossein, Sherkatolabbasieh Hamid Reza, Abedini-Varamini Masoumeh, Rahmati Mohammad Bagher, Movahedi Faezeh Sadat, Rezai Mohammad Sadegh
Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Research Center of Tropical and Infectious Diseases, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Front Pediatr. 2023 Jan 11;10:988371. doi: 10.3389/fped.2022.988371. eCollection 2022.
Kawasaki disease(KD) is a vasculitis of childhood that tends to influence the coronary arteries. There is no national data about the prevalence of KD in Iran. This study aimed to perform a national registry in Iran for 13 years.
In this retrospective study, the data for KD extracted from medical records of <19 year-old patients admitted to tertiary hospitals in Iran between 2007 and 2019 were recorded in the national KD registry system. Age, admission date, gender, location, and presence of KD criteria, laboratory and echocardiography findings, and treatment modalities were evaluated. Complete KD was considered if ≥4 clinical criteria of the KD existed and otherwise, incomplete KD was considered.
Data from 1,682 KD patients including 999(59.39%) boys and 683(40.61%) girls and male/female ratio of 1.46 were evaluated. The mean age was 3.08 ± 2.49 years and 1465(87%) were living in urban regions. The yearly incidence of the disease was between 2.62 to 3.03 from 2015 to 2019. The highest age-specific incidence was observed in children <1-year-old. Incomplete and resistant KD included 1,321(78.54%) and 9(0.54%) patients, respectively. Abnormal echocardiography was detected in 619(36.80%) patients. Leukocytosis, with dominancy of neutrophils, anemia, thrombocytosis and increased ESR and CRP were the most noticeable laboratory findings. No death due to KD disease was reported.
Based on this study, most of the KD cases are presented with atypical presentation in Iran. So, increasing awareness of primary healthcare workers by educating and updating their data is very important in timely diagnosis and management of the disease.
川崎病(KD)是一种儿童血管炎,易影响冠状动脉。伊朗尚无关于KD患病率的全国性数据。本研究旨在对伊朗进行为期13年的全国登记。
在这项回顾性研究中,从2007年至2019年期间入住伊朗三级医院的19岁以下患者的病历中提取的KD数据记录在全国KD登记系统中。对年龄、入院日期、性别、地点、KD标准的存在情况、实验室和超声心动图检查结果以及治疗方式进行了评估。如果存在≥4条KD临床标准,则视为完全KD,否则视为不完全KD。
评估了1682例KD患者的数据,其中包括999例(59.39%)男孩和683例(40.61%)女孩,男女比例为1.46。平均年龄为3.08±2.49岁,1465例(87%)居住在城市地区。2015年至2019年该疾病的年发病率在2.62至3.03之间。1岁以下儿童的年龄特异性发病率最高。不完全KD和难治性KD分别包括1321例(78.54%)和9例(0.54%)患者。619例(36.80%)患者检测到超声心动图异常。白细胞增多,以中性粒细胞为主,贫血,血小板增多以及血沉和C反应蛋白升高是最显著的实验室检查结果。未报告因KD疾病导致的死亡。
基于本研究,伊朗大多数KD病例表现为非典型症状。因此,通过教育和更新数据来提高基层医护人员的认识,对于该疾病的及时诊断和管理非常重要。