Pepartment of Pediatrics, Konyang University Hospital, Daejeon, Korea.
Chungbuk National Univeristy Hospital, Sunhwan-Ro 776, Seowoneowon-Gu 1, Cheongju-Si, Chungcheongbuk-Do, 28644, Republic of Korea.
BMC Pediatr. 2024 Oct 10;24(1):644. doi: 10.1186/s12887-024-05133-y.
Kawasaki disease (KD) is a significant cause of acquired heart disease in children, particularly in developed countries. Incomplete Kawasaki disease (IKD) lacks some of the classic KD symptoms, complicating diagnosis. This study explores the potential role of anterior uveitis (AU) as a diagnostic marker for IKD and its possible association with reducing the incidence of coronary artery lesions (CALs).
A retrospective review of medical records was conducted on 111 pediatric patients diagnosed with IKD at two tertiary care centers between January 2018 and December 2023. The cohort consisted of 33 patients with AU and 78 without AU. The AU group had a mean age of 4.1 years, while the non-AU group had a mean age of 4.5 years. AU was present in 30% of cases. The study primarily focused on the time to diagnosis, incidence of CALs, and the independent association of AU with CALs using multivariate logistic regression analysis.
Patients with AU were diagnosed and treated earlier, with a mean time to diagnosis of 5.1 days compared to 7.4 days in the non-AU group. Additionally, the incidence of CALs was significantly lower in the AU group (4.4%) compared to the non-AU group (31.8%, p < 0.001). Multivariate analysis revealed that AU was independently associated with a significantly reduced risk of CALs (OR = 0.066, 95% CI = 0.009-0.494, P = 0.008).
This study suggests that AU may be associated with earlier diagnosis and treatment of IKD, potentially lowering the risk of CALs. While AU shows promise as a diagnostic marker, further prospective studies are needed to validate these findings and determine whether AU should be integrated into clinical guidelines for earlier detection of IKD and improved patient outcomes.
川崎病（KD）是儿童获得性心脏病的一个重要病因，尤其是在发达国家。不完全川崎病（IKD）缺乏一些经典川崎病的症状，这使得诊断变得复杂。本研究探讨前葡萄膜炎（AU）作为 IKD 诊断标志物的潜在作用及其与降低冠状动脉病变（CALs）发生率的可能关联。
对 2018 年 1 月至 2023 年 12 月在两家三级保健中心被诊断为 IKD 的 111 例儿科患者的病历进行了回顾性分析。该队列包括 33 例有 AU 的患者和 78 例无 AU 的患者。AU 组的平均年龄为 4.1 岁，非 AU 组的平均年龄为 4.5 岁。AU 出现在 30%的病例中。该研究主要关注诊断时间、CALs 的发生率以及 AU 与 CALs 的独立相关性，使用多变量 logistic 回归分析。
有 AU 的患者的诊断和治疗时间更早，平均诊断时间为 5.1 天，而无 AU 组为 7.4 天。此外，AU 组的 CALs 发生率明显较低（4.4%比非 AU 组的 31.8%，p<0.001）。多变量分析显示，AU 与 CALs 的发生风险显著降低独立相关（OR=0.066，95%CI=0.009-0.494，P=0.008）。
本研究表明，AU 可能与 IKD 的早期诊断和治疗相关，从而降低 CALs 的风险。虽然 AU 作为一种诊断标志物具有一定的前景，但需要进一步的前瞻性研究来验证这些发现，并确定 AU 是否应纳入临床指南，以更早地发现 IKD 并改善患者结局。
