Al Zubaidi Abdulqader, Ghatasheh Ghassan, Karuppaswamy Venkatachalam, Narchi Hassib
Department of Academic Affairs, Tawam Hospital, Al Ain, ARE.
Department of Pediatric Infectious Diseases, Tawam Hospital, Al Ain, ARE.
Cureus. 2023 Dec 30;15(12):e51320. doi: 10.7759/cureus.51320. eCollection 2023 Dec.
Background and objective Kawasaki disease is a childhood vasculitis, the leading cause of acquired heart disease in children worldwide. Data is lacking in the United Arab Emirates and the Middle East region. We aimed to review the clinical characteristics of patients diagnosed with Kawasaki disease, the response to intravenous immunoglobulin, and the short-term and long-term echocardiographic findings. Study design This is a retrospective cohort study involving patients diagnosed with Kawasaki disease in Tawam Hospital from January 2011 to December 2021. Results A total of 74 patients with a mean age of 36 months were diagnosed with Kawasaki disease, of whom 18 (24%) were below one year of age. Complete Kawasaki disease criteria were fulfilled in 36 patients (49%), while the remaining 38 (51%) were incomplete Kawasaki disease. A positive response to intravenous immunoglobulin occurred in less than 36 hours in 60 patients (84.5%). Echocardiography at the diagnosis of Kawasaki disease was performed on 71 patients, of whom 18 (25.35%) had cardiac involvement. The odds of coronary artery aneurysms in Kawasaki disease were 0.12 at diagnosis. Patients younger than 12 months were significantly more likely to be diagnosed with incomplete Kawasaki disease as compared to older patients (24 vs. 14 patients, = 0.01). In the multivariate logistic regression analysis, only corticosteroid therapy remained statistically significantly associated with the development of coronary aneurysms (adjusted odds ratio (OR) 13.02, ci 1.05, 161.18; = 0.045). Conclusion A high proportion of patients with Kawasaki disease had an atypical presentation, especially when under one year of age. There was no association between clinical characteristics or laboratory findings and prompt response to treatment within 36 hours.
背景与目的 川崎病是一种儿童血管炎，是全球儿童后天性心脏病的主要病因。阿拉伯联合酋长国和中东地区缺乏相关数据。我们旨在回顾川崎病确诊患者的临床特征、静脉注射免疫球蛋白的反应以及短期和长期超声心动图检查结果。研究设计 这是一项回顾性队列研究，涉及2011年1月至2021年12月在塔瓦姆医院确诊为川崎病的患者。结果 共有74例平均年龄为36个月的患者被诊断为川崎病，其中18例（24%）年龄在1岁以下。36例患者（49%）符合完全川崎病标准，其余38例（51%）为不完全川崎病。60例患者（84.5%）在36小时内对静脉注射免疫球蛋白有阳性反应。71例川崎病确诊患者进行了超声心动图检查，其中18例（25.35%）有心脏受累。川崎病诊断时冠状动脉瘤的发生率为0.12。与年龄较大的患者相比，12个月以下的患者被诊断为不完全川崎病的可能性显著更高（24例对14例，P = 0.01）。在多因素逻辑回归分析中，只有皮质类固醇治疗与冠状动脉瘤的发生仍有统计学显著相关性（调整后的优势比（OR）为13.02，95%置信区间为1.05，161.18；P = 0.045）。结论 川崎病患者中很大一部分表现不典型，尤其是1岁以下的患者。临床特征或实验室检查结果与36小时内对治疗的迅速反应之间没有关联。
