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Extracardiovascular injury complications in Kawasaki disease
Jie Liu1, Yuqin Huang1, Suyuan Qin1
1Department of Pediatrics First Affiliated Hospital Guangxi Medical University Nanning China.
Insights
Kawasaki disease (KD) can affect multiple organs, with extracardiovascular complications varying by age. Nervous system involvement is more frequent in patients not responding to intravenous immunoglobulin (IVIG) therapy.
Area of Science:
- Pediatrics
- Rheumatology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is a critical pediatric illness.
- Extracardiovascular complications in KD can significantly impact patient outcomes.
- Understanding these complications is vital for comprehensive patient management.
Purpose of the Study:
- To determine the incidence and clinical features of extracardiovascular complications in children with KD.
- To analyze how age, IVIG responsiveness, and coronary status influence these complications.
Main Methods:
- Retrospective review of clinical data from 511 KD patients (2003-2021).
- Comparison of extracardiovascular complications based on age, IVIG response, and coronary artery lesions (CALs).
Main Results:
- Younger children (<1 year) and boys showed higher rates of CALs.
- Hematologic system involvement decreased with age, while joint involvement increased.
- Nervous system involvement was significantly more common in IVIG non-responders (15.7%) compared to responders (5.4%).
- No significant difference in extracardiovascular complications was found between patients with or without CALs.
Conclusions:
- Kawasaki disease involves multiple organ systems beyond the cardiovascular system.
- Nervous system complications are a notable concern in IVIG non-responsive KD patients.
- Age-related patterns exist for hematologic and joint involvement in KD.
Importance:
Patients with Kawasaki disease (KD) experience various extracardiovascular injury complications, which may affect their outcomes.
Objective:
To investigate the incidence and clinical characteristics of extracardiovascular complications in children with KD.
Methods:
The clinical data of patients diagnosed with KD in the First Affiliated Hospital of Guangxi Medical University from January 2003 to January 2021 were reviewed. The clinical characteristics and extracardiovascular complications were compared among patients stratified by age, intravenous immunoglobulin (IVIG) therapy responsiveness, and coronary status.
Results:
A total of 511 patients with KD were included, 357 (69.9%) were aged 1-5 years. Children aged <1 year (21.5%) and boys (70.8%) were more likely to have coronary artery lesions (CALs). The incidence of incomplete KD was lowest in 1-5-year-old patients (19.6%). Involvement of the hematological system gradually decreased with age (<1 year, 51.8%; 1-5 years, 36.7%; >5 years, 29.5%), whereas the involvement of the joints gradually increased with age (<1 year, 2.7%; 1-5 years, 6.2%; >5 years, 20.5%). Nervous system involvement was more common in IVIG non-responders (15.7% [13/83] vs. 5.4% [23/428], P = 0.001). However, there were no significant differences in extracardiovascular injury complications between patients with or without CALs.
Interpretation:
KD can involve multiple organ injuries as well as cardiovascular complications, and nervous systerm involvement may be more common in patients unresponsive to IVIG.
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