Clinical manifestations of Kawasaki disease shock syndrome: A case-control study
Clinical manifestations of Kawasaki disease shock syndrome: A case-control study
复制标题
DOI：
10.1016/j.jmii.2013.06.005
复制
发表时间：
2015-02-01
影响因子：
7.4
通讯作者：
Chiu, Nan-Chang
中科院分区：
文献类型：
--
作者：
Chen, Pei-Shin;Chi, Hsin;Chiu, Nan-Chang
背景：川崎病休克综合征（KDSS）是与川崎病（KD）相关的严重疾病，有时很难诊断。这是一项病例对照研究，旨在确定 KDSS 儿童的临床表现、危险因素和临床结局。 材料和方法：对 2001 年至 2011 年住院的诊断为 KD 合并低血压、脓毒症或休克的儿童进行回顾性分析，并将其定义为病例患者。对于每个病例患者，确定三名季节匹配、血压正常、诊断为川崎病的患者作为对照患者。对人口学特征、临床表现、实验室特征、治疗和结果进行了分析。结果：确定了 9 名 KDSS 患者和 27 名对照患者。 KDSS 患者的平均年龄为 3.2 +/- 3.2 岁。与对照组相比，KDSS 患者入院时诊断为 KD 的可能性较低（22.2% vs. 66.7%），并且冠状动脉扩张的风险较高（77.8% vs. 11.1%）。 KDSS 的危险因素包括较高的中性粒细胞计数和条带比例、较高的 C 反应蛋白 (CRP) 和较低的血小板计数。所有病例均接受阿司匹林治疗；八名患者接受了静脉注射免疫球蛋白治疗，其中两人接受了超过一个疗程的治疗。 7例KDSS患者需要液体复苏，8例患者需要血管活性输注。结论：KDSS患者的临床病程可能不均匀，一开始可能被误诊。他们在早期可能有更显着的炎症标志物，并且冠状动脉扩张的风险更高。版权所有(C) 2013，台湾微生物学会。由爱思唯尔台湾有限公司出版。版权所有。
Background: Kawasaki disease shock syndrome (KDSS) is a severe condition related to Kawasaki disease (KD), and sometimes it is difficult to diagnose. This is a case-control study to ascertain the clinical presentations, risk factors, and clinical outcomes of children who had KDSS.Materials and methods: Children who were hospitalized during 2001-2011 with the diagnosis of KD combined with hypotension, sepsis, or shock were retrospectively reviewed and were defined as case patients. For each case patient, three season-matched patients diagnosed as having KD with normal blood pressure were identified to serve as control patients. Demographic characteristics, clinical presentations, laboratory features, therapies, and outcomes were analyzed.Results: Nine KDSS patients and 27 control patients were identified. The average age of patients with KDSS was 3.2 +/- 3.2 years. Compared with controls, KDSS patients were less likely to have a diagnosis of KD at admission (22.2% vs. 66.7%) and had a higher risk of coronary artery dilatation (77.8% vs. 11.1%). Risk factors for KDSS included higher neutrophil counts and proportions of bands, higher C-reactive protein (CRP), and lower platelet counts. All case patients received aspirin therapy; eight patients received intravenous immunoglobulin therapy, with two receiving more than one course. Seven KDSS patients required fluid resuscitation, and eight patients required vasoactive infusions.Conclusion: Patients with KDSS may have uneven clinical course and may be misdiagnosed in the beginning. They may have more prominent inflammatory markers in the early phase and higher risk of coronary artery dilatation. Copyright (C) 2013, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.