Clinical manifestations of Kawasaki disease shock syndrome: A case-control study
Resource
J. Microbiol. Immunol. Infect., 48(1), 43-50
Journal
J. Microbiol. Immunol. Infect.
Journal Volume
48
Journal Issue
1
Pages
43-50
Date Issued
2015
Date
2015
Author(s)
Chen, Pei-Shin
Chi, Hsin
Huang, Fu-Yuan
Peng, Chun-Chih
Chen, Ming-Ren
Chiu, Nan-Chang
Abstract
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.
Subjects
Children
Kawasaki disease
Kawasaki disease shock syndrome
Risk factors
SDGs