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[Prospective study of 64 cases of Kawasaki's disease]
Insights
This study on Kawasaki disease in children identified common symptoms alongside less frequent complications like tympanic membrane hyperemia and acute kidney failure. It highlights key laboratory findings and the importance of monitoring inflammatory markers and organ-specific involvement.
Area of Science:
- Pediatrics
- Infectious Diseases
- Rheumatology
Context:
- Kawasaki disease is a critical pediatric illness.
- Early diagnosis and management are crucial to prevent cardiac complications.
- This study examines a cohort of children diagnosed with Kawasaki disease.
Purpose:
- To document the clinical presentation and laboratory findings in children with Kawasaki disease.
- To identify less common clinical signs and complications associated with the disease.
- To analyze the temporal changes in inflammatory markers and hematological parameters.
Summary:
- The study prospectively analyzed 64 children with Kawasaki disease, observing typical symptoms alongside hyperemia of the tympanic membrane (27%), uveitis (17%), syndrome of inappropriate secretion of antidiuretic hormone (9%), hydrops of the gallbladder (8%), and pulmonary infiltrations (5%).
- Notable complications included acute kidney failure in one patient and renal artery stenosis in another. White blood cells in urinary sediment were observed in 8 patients.
- Laboratory findings revealed accelerated sedimentation, decreased hemoglobin, elevated white blood cell counts around day 10, low albumin, and increased levels of alpha-1-globulin, alpha-2-globulin, IgA, IgM, SGOT, SGPT, bilirubin, and C-reactive protein (CRP).
- Viral studies were positive in 12 out of 37 patients.
Impact:
- Provides comprehensive data on the diverse clinical spectrum of Kawasaki disease in children.
- Emphasizes the need for vigilance regarding less common but serious complications, including renal involvement.
- Contributes to understanding the inflammatory and immunological profile of the disease, aiding in diagnostic and prognostic assessments.
Abstract:
We prospectively studied 64 children with Kawasaki disease. The well recognized signs were seen, but we also found hyperemia of the tympanic membrane in 27%, uveitis in 17%, syndrome of inappropriate secretion of anti-diuretic hormone in 9%, hydrops of the gallbladder in 8%, pulmonary infiltrations in 5% and one death. One patient presented with acute kidney failure, another one presented with stenosis of the renal artery, and 8 presented white blood cells (WBC) in the urinary sediment. Sedimentation was accelerated and there was an important decrease in hemoglobin blood level around the 5th day of illness. The WBC count rose around the 10th day; thereafter, all these results returned to normal while platelets counts rose. Albumin blood level was low, and all the following data were higher than normal: alpha-1-globulin, alpha-2-globulin, IgA, IgM, SGOT, SGPT, bilirubin and CRP. Viral studies were performed in 37 patients; 12 showed positive results.