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Ocular manifestations of Kawasaki's disease (mucocutaneous lymph node syndrome)
Insights
Kawasaki's disease (mucocutaneous lymph node syndrome) commonly causes bilateral eye inflammation, including conjunctivitis and iridocyclitis, in children. Ocular symptoms correlate with inflammatory markers but serious complications are rare.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Background:
- Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is a leading cause of acquired heart disease in children.
- Ocular manifestations are common in KD but require further characterization.
Purpose of the Study:
- To prospectively investigate the spectrum and frequency of ocular findings in children diagnosed with Kawasaki disease.
- To explore correlations between ocular inflammation and systemic inflammatory markers.
Main Methods:
- Prospective observational study involving 18 children diagnosed with Kawasaki disease.
- Ophthalmic examinations were performed to document ocular manifestations.
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured.
Main Results:
- Bilateral bulbar conjunctival injection (89%) and iridocyclitis (78%) were the most frequent findings.
- Superficial punctate keratitis, vitreous opacities, papilledema, and subconjunctival hemorrhage were less common.
- Significant positive correlations were observed between ocular inflammation and elevated ESR (P < .0001) and CRP (P < .0009).
Conclusions:
- Ocular inflammation, particularly conjunctivitis and iridocyclitis, is highly prevalent in children with Kawasaki disease.
- The severity of ocular inflammation correlates with systemic inflammatory markers.
- Serious ocular complications were not observed in this cohort, suggesting a generally favorable visual prognosis.
Abstract:
In a prospective study of the ocular manifestations of Kawasaki's disease (mucocutaneous lymph node syndrome) in 18 children (11 boys and seven girls, ranging in age from 5 months to 9 years), we found bilateral injection of the bulbar conjunctiva in 16, bilateral iridocyclitis in 14, superficial punctate keratitis in four, vitreous opacities in two, papilledema in two, and subconjunctival hemorrhage in one. Conjunctival injection and iridocyclitis were always bilateral, and fellow eyes always had the same degree of inflammation. There were significant correlations between ocular inflammation and erythrocyte sedimentation rate (P less than .0001) and C-reactive protein level (P less than .0009). No serious ocular complications occurred.