Recurrent Kawasaki disease: USA and Japan.
Recurrent Kawasaki disease: USA and Japan.
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经常性川崎病：美国和日本。
DOI：
10.1111/ped.12733
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发表时间：
2015-12
期刊：
影响因子：
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通讯作者：
Belay ED
中科院分区：
文献类型：
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作者：
Maddox RA;Holman RC;Uehara R;Callinan LS;Guest JL;Schonberger LB;Nakamura Y;Yashiro M;Belay ED
复发性和非复发性川崎病（KD）的描述性流行病学研究可以确定这些疾病之间其他潜在的重要差异。分别分析了美国和日本疾病控制和预防中心（CDC）国家KD监测（1984-2008）和日本第17次全国调查（2001-2002）的数据，以检查≥18岁符合CDC KD病例或非典型KD病例定义的复发KD患者。将这些患者与非复发性KD患者进行比较。1984-2008年间，5557名年龄<18岁的美国KD患者中，97名（1.7%）被确定为复发性KD。在美国亚洲/太平洋岛民KD患者中，3.5%有复发性KD，这与日本调查中KD患者的比例（3.5%）相似。与非复发性KD患者相比，经历复发性KD发作的KD患者更可能年龄较大，符合非典型KD病例定义，并且尽管进行了IVIG治疗，但仍有冠状动脉异常（CAA）。复发性和非复发性KD患者在年龄、种族和CAA发生频率上存在差异。CAA与复发性KD的相关性增加表明，对于KD的第二次发作，可能需要更积极的治疗策略，并结合IVIG。
Descriptive epidemiologic studies of recurrent and non-recurrent Kawasaki disease (KD) may identify other potentially important differences between these illnesses. Data from the United States and Japan, the Centers for Disease Control and Prevention (CDC) national KD surveillance (1984–2008) and the 17th Japanese nationwide survey (2001–2002), respectively, were analyzed to examine recurrent KD patients <18 years of age meeting the CDC KD case or atypical KD case definition. These patients were compared to non-recurrent KD patients. Of the 5557 US KD patients <18 years of age during 1984–2008, 97 (1.7%) were identified as having had recurrent KD. Among the US Asian/Pacific Islander KD patients, 3.5% had recurrent KD, which was similar to the percentage identified among KD patients (3.5%) in the Japanese survey. Compared to non-recurrent KD patients, KD patients experiencing a recurrent KD episode were more likely to be older, fulfill the atypical KD case definition, and have coronary artery abnormalities (CAA) despite IVIG treatment. Differences in the age, race, and frequency of CAA exist between recurrent and non-recurrent KD patients. The increased association of CAA with recurrent KD suggests that more aggressive treatment strategies in conjunction with IVIG may be indicated for the second episode of KD.