Kawasaki Disease at the Extremes of the Age Spectrum
Kawasaki Disease at the Extremes of the Age Spectrum
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DOI：
10.1542/peds.2009-0099
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发表时间：
2009-09-01
期刊：
影响因子：
8
通讯作者：
McCrindle, Brian W.
中科院分区：
文献类型：
--
作者：
Manlhiot, Cedric;Yeung, Rae S. M.;McCrindle, Brian W.
目的：我们试图确定川崎病（KD）的结果，并探讨与不良临床结果的患者诊断年龄范围以外的1至4 years.METHODS：1990年1月和2007年4月之间的所有患者的数据进行了回顾性分析。根据诊断时的年龄将患者分为5组。结果：共确定了1374例患者; 61例（4%）诊断时年龄< 6个月，114例（8%）6个月至< 1岁，854例（62%）1至4岁，258例（19%）5至9岁，87例（6%）> 9岁。9< 1 year of age and those >岁的患者比1 - 4岁的患者更容易发生冠状动脉异常。5至9岁的患者被诊断为风险最低。年龄谱的两个极端的患者更有可能表现出< 4个经典KD特征，但只有5岁的患者< 6 months or >在发病后> 12天被诊断的风险增加。年龄< 6个月的患者白蛋白水平较低，年龄< 1岁的患者白色细胞和血小板计数较高，所有这些都是已知的冠状动脉异常的预测因子。> 9岁的患者不太可能接受静脉注射免疫球蛋白treatment.CONCLUSION：结果诊断为KD的儿童在任何极端的年龄谱是次优的，虽然相关的因素是不同的。儿科2009; 124：e410-e415
OBJECTIVE: We sought to determine outcomes of Kawasaki disease (KD) and to explore factors associated with poor clinical outcomes for patients diagnosed outside the age range of 1 to 4 years.METHODS: A retrospective review of data for all patients seen between January 1990 and April 2007 was performed. Patients were stratified into 5 groups on the basis of age at diagnosis.RESULTS: A total of 1374 patients were identified; 61 (4%) were < 6 months of age at diagnosis, 114 (8%) 6 months to < 1 year, 854 (62%) 1 to 4 years, 258 (19%) 5 to 9 years, and 87 (6%) > 9 years. Patients < 1 year of age and those > 9 years of age were more likely to have coronary artery abnormalities than were patients diagnosed between 1 and 4 years of age. Patients diagnosed between the ages of 5 and 9 years were at the lowest risk. Patients at both extremes of the age spectrum were more likely to present with < 4 of the classic KD features, but only those < 6 months or > 5 years of age were at increased risk of being diagnosed > 12 days after illness onset. Patients < 6 months of age had lower albumin levels, and those < 1 year of age had higher white blood cell and platelet counts, all of which are known predictors of coronary artery abnormalities. Patients > 9 years of age were less likely to receive intravenous immunoglobulin treatment.CONCLUSION: Outcomes for children diagnosed with KD at either extreme of the age spectrum are suboptimal, although the associated factors are different. Pediatrics 2009; 124: e410-e415