Clinical analysis of recurrent Kawasaki disease in children
10.3760/cma.j.issn.1673-4912.2021.09.013
- VernacularTitle:儿童复发川崎病的临床分析
- Author:
Xinyuan CHU
1
;
Xi CHEN
;
Qirui LI
;
Zhen ZHEN
;
Lu GAO
;
Wen YU
;
Yue YUAN
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院心脏内科 100045
- Keywords:
Kawasaki disease;
Recurrent;
Clinical analysis
- From:
Chinese Pediatric Emergency Medicine
2021;28(9):806-809
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To provide a theoretical basis for diagnosing and treating recurrent Kawasaki disease based on data analysis of clinical symptoms.Methods:Data analysis of children with recurrent Kawasaki disease admitted to Beijing Children′s Hospital of Capital Medical University from January 2016 to December 2019 was conducted, including comparisons of the initial onset and the recurrence on patients′ clinical features, auxiliary examination and treatment.Results:During the four-year scale, 3 041 children with Kawasaki disease were admitted to the department of Cardiology.The recurrence data involved 65 children[male∶female 3.1∶1, average aged(2.42 ± 2.04) years]. First, children′s fever duration was(5.66 ± 2.37) days in recurrence data, significantly shorter than that of their initial onset.The recurrence data also reported a lower incidence of rash and limb changes, together with respiratory and gastrointestinal symptoms.Then, 19 cases out of the 65 children got coronary artery lesion(CAL) at their initial onset.A relief of CAL was reported from 15 children when the disease recurred, along with 11 new-reported CAL cases.Intravenous immunoglobulin(IVIG) refractory Kawasaki disease cases accounted for nine at the initial onset and 12 at the recurrent onset, respectively.Five IVIG refractory recurrent cases reported significant relief after 2 g/kg IVIG treatment.Conclusion:The recurrent Kawasaki disease in children usually occurs among children under three years old, within the first year after the initial onset.Most of the recurrent cases report a shorter fever duration and less typical clinical symptoms than their first onset.In some cases, IVIG treatment showed effects initially but failed to work when the disease recurred.Therefore, glucocorticoid or infliximab should be considered for further treatment.
