Kenza Bouayed, Maryam Jalal, Asmaa Sakhi, Ghita Benbrahim Ansar, Hanan Aboufaris, Abdenasser Drighil
Department of Pediatric Rheumatology, A Harouchi Mother and Child Hospital, CHU Ibn Rochd, Casablanca, Morocco.
Hassan II University Faculty of Medicine and Pharmacy, Casablanca, Morocco.
Turk Arch Pediatr. 2025 Jul 1;60(4):426-433. doi: 10.5152/TurkArchPediatr.2025.25053.
Objective: Kawasaki disease (KD) is one of the most common systemic vasculitides and a cause of acquired heart disease in children. The aim was to provide an epidemiological picture of KD with an emphasis on cardiac involvement in Morocco. Materials and Methods: This is a cross-sectional observational study recruiting patients with KD between January 2019 and December 2023. Diagnosis was based on 2017 American Heart Association criteria under the supervision of an expert. Statistical analysis was carried out using the chi-square, Mann-Whitney U, and Fisher's exact tests. Results: Sixty-nine patients were admitted; the mean age was 36 months, the sex ratio was 1.6 (male:female), and the mean days to the first consultation was 10.1. Thirty-nine cases met the criteria for complete forms and 30 for incomplete forms. Coronary dilatations and aneurysms were found in 20 and 7 patients respectively, including 3 giant aneurysms. All patients were treated with intravenous immunoglobulin (IVIG) except 1 and acetylsalicylic acid (ASA), and 23.1% received corticosteroids. Fourteen patients (20.3%) were resistant and 4.3% could benefit from a rescue treatment including second IVIG, Anakinra, and corticosteroids. Six predictive factors of coronary involvement were analyzed and were significant for age ≤ 12 months and ≥ 60 months and delay in IVIG infusion of more than 10 days (P= .045/P = .017). Conclusion: This study demonstrates the importance of raising awareness of KD among primary care physicians, given that a significant proportion of patients were referred from day 10 of fever onward, and paying more attention to extreme ages where coronary involvement is more common.
川崎病(KD)是儿童最常见的系统性血管炎之一,也是后天性心脏病的病因。本研究旨在呈现摩洛哥川崎病的流行病学情况,重点关注心脏受累情况。材料与方法:这是一项横断面观察性研究,纳入了2019年1月至2023年12月期间的川崎病患者。诊断依据2017年美国心脏协会标准,由专家监督进行。采用卡方检验、曼-惠特尼U检验和费舍尔精确检验进行统计分析。结果:共收治69例患者;平均年龄为36个月,性别比为1.6(男:女),首次就诊的平均天数为10.1天。39例符合完全型标准,30例符合不完全型标准。分别在20例和7例患者中发现冠状动脉扩张和动脉瘤,其中包括3例巨大动脉瘤。除1例患者外,所有患者均接受了静脉注射免疫球蛋白(IVIG)和乙酰水杨酸(ASA)治疗,23.1%的患者接受了皮质类固醇治疗。14例患者(20.3%)治疗抵抗,4.3%的患者可从包括第二次IVIG、阿那白滞素和皮质类固醇的挽救治疗中获益。分析了6个冠状动脉受累的预测因素,年龄≤12个月和≥60个月以及IVIG输注延迟超过10天具有统计学意义(P = .045/P = .017)。结论:本研究表明提高基层医疗医生对川崎病的认识非常重要,因为相当一部分患者从发热第10天起就被转诊,同时应更加关注冠状动脉受累更常见的极端年龄。