川崎病的非心脏后遗症。90例调查研究及文献复习

Lekarz wojskowy Pub Date : 2023-09-30 DOI:10.53301/lw/166375
Magdalena Okarska-Napierała, Anna Zacharzewska, Katarzyna Smyk, Emilia Linkowska, Ernest Kuchar
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引用次数: 0

摘要

简介与目的川崎病最常见的长期并发症是冠状动脉瘤。然而,也有许多关于其他不寻常的慢性并发症的病例报告。这些数据只是道听途说,缺乏更系统的观察。我们的目的是检测和描述KD的慢性非心脏并发症。材料与方法采用标准化问卷,对2014 - 2019年诊断为KD患儿的家长进行电话调查。从护理人员处记录有关疾病急性期、治疗、结局以及KD诊断后3个月内观察到的症状和体征的临床资料。我们从华沙的三家儿童医院和社交媒体上的一个支持小组招募了儿童。结果90例患儿符合纳入标准。30名儿童(33%)的父母报告了一些神经系统后遗症,其中持续易怒是最常见的,其次是睡眠障碍、攻击性和慢性疲劳。17名儿童(19%)在上肢和下肢出现关节痛或非特异性疼痛。在9名儿童(10%)中,特应性皮炎或脂溢性皮炎在KD后不久开始。5例患儿(6%)出现眼部并发症。结论KD急性期可出现多种非特异性并发症。虽然相关性并不意味着因果关系,而且观察到的异常的可能解释有很多,但我们的数据可能会提高临床医生对儿童KD后观察到的常见和鲜为人知的发现的认识。这也可能有助于让家长们放心,他们所观察到的是一种常见的、通常是短暂的KD后遗症。
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Non-cardiac sequelae of Kawasaki Disease. The survey study of 90 cases and literature review
Introduction and objective The best-known long-term complications of Kawasaki Disease (KD) are coronary artery aneurysms. However, there are numerous case reports about other unusual chronic complications. These data are only anecdotal, and more systematic observation is missing. We aimed to detect and describe chronic non-cardiac complications of KD. Material and methods We surveyed parents of children with KD diagnosed between 2014 and 2019 by phone with the use of standardized questionnaire. Clinical data about the acute phase of the disease, treatment, outcome, and symptoms and signs observed within three months since KD diagnosis were recorded from the caregivers. We recruited children from 3 children’s hospitals in Warsaw and a support group on social media. Results Ninety children met the inclusion criteria. Parents of 30 children (33%) reported some neurologic sequelae, with persistent irritability being the most common, followed by sleep disturbances, aggression, and chronic fatigue. Seventeen children (19%) suffered either arthralgia or unspecific pain in the upper and lower extremities. In nine children (10%), either atopic or seborrheic dermatitis began shortly after KD. Five children (6%) presented with ophthalmic complications. Conclusions Various unspecific complications may emerge after the acute phase of KD. Although correlation does not imply causation, and possible explanations of observed abnormalities are numerous, our data may enhance clinicians’ awareness of frequent and poorly understood findings observed after KD in children. It also might help reassure parents that what they observe lies within a range of common and usually transient KD sequelae.
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