Heterogeneous neurodevelopmental disorders in children with Kawasaki disease: what is new today?
Chien-Heng Lin1,2, Wei-De Lin3, I-Ching Chou4,5
1Division of Pediatrics Pulmonology, China Medical Univeristy Children's Hospital, Taichung, Taiwan.
Insights
Children with Kawasaki disease (KD) have a higher risk of neurodevelopmental disorders (NDDs), particularly epilepsy and Tourette syndrome (TS). This study highlights the need for monitoring NDDs in pediatric KD patients.
Area of Science:
- Pediatric Neurology
- Childhood Vasculitis
- Neurodevelopmental Disorders
Background:
- Kawasaki disease (KD) is a prevalent childhood vasculitis in East Asia.
- Long-term cardiovascular complications of KD are well-documented, but neurodevelopmental outcomes require further investigation.
- Previous studies on neurodevelopmental problems post-KD have yielded inconsistent findings.
Purpose of the Study:
- To investigate the prevalence of epilepsy and associated neurodevelopmental disorders (NDDs) in Taiwanese children diagnosed with KD.
- To compare the incidence of these disorders in KD patients with the general pediatric population.
Main Methods:
- Retrospective analysis of children under 18 diagnosed with KD between 2005 and 2015.
- Follow-up of KD patients to assess the prevalence of epilepsy and NDDs.
- Comparison with national and global prevalence data for the general pediatric population.
Main Results:
- 16.8% of 612 KD patients exhibited NDDs, including epilepsy, intellectual disability (ID), autism spectrum disorders, Tourette syndrome (TS), and ADHD.
- KD patients showed significantly higher prevalence rates for epilepsy (2.61% vs. 0.33%) and TS (2.77% vs. 0.56%) compared to the general Taiwanese population.
- No significant difference in the prevalence of ID, ADHD, or developmental language disorders was observed.
Conclusions:
- Taiwanese children with KD demonstrate a higher prevalence of NDDs, specifically epilepsy and TS, compared to their peers without KD.
- The observed NDDs can be heterogeneous, necessitating continued follow-up for KD patients.
- KD diagnosis is associated with an increased risk for various neurodevelopmental disorders.
Background:
Kawasaki disease (KD) is a common vasculitis of childhood in East Asia. The complications of KD ascribed to long-term cardiovascular sequelae are considerably diverse. Although studies have investigated neurodevelopmental problems following KD in the past few decades, they have reported inconsistent conclusions. This study investigated potential epilepsy and associated neurodevelopmental disorders (NDDs) following KD in Taiwanese children.
Methods:
We retrospectively analyzed the data of children aged < 18 years with clinically diagnosed KD from January 1, 2005, to December 31, 2015. These patients were followed up to estimate the prevalence of epilepsy and associated NDDs in comparison with the prevalence in general pediatric population in Taiwan and worldwide.
Results:
A total of 612 patients with an average age of 1.6 years were included. The prevalence of associated NDDs was 16.8% (n = 103/612) in the study group, which consisted of epilepsy, intellectual disability (ID), autism spectrum disorders, Tourette syndrome (TS), attention deficit hyperactivity disorder, (ADHD), and others. Moreover, children with KD had a higher prevalence of epilepsy and TS in both Taiwan and worldwide (epilepsy: 2.61% in the KD group vs 0.33% in Taiwan and 0.05-0.8% in worldwide, p < 0.05; TS: 2.77% in the KD group vs 0.56% in Taiwan and 0.3-1% in worldwide, p < 0.05). The prevalence of ID, ADHD, and developmental language disorders was not significantly different between our study patients and those in Taiwan or worldwide.
Conclusions:
Results revealed a higher prevalence rate of NDDs, especially epilepsy and TS, in Taiwanese children with KD than in the general pediatric population in Taiwan. However, these NDDs could be heterogeneous. Children diagnosed with KD were followed up because they had a higher risk of heterogeneous NDDs.
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