ผลลัพท์ทางคลินิกของผู้ป่วยเด็กโรคคาวาซากิ: Clinical Outcomes of Kawasaki Disease in Children

บทคัดย่อ

Kawasaki disease (KD), a systemic vasculitis affecting predominantly medium-sized arteries, is the leading cause of acquired heart disease in children. The most serious complication is coronary artery aneurysm (CAA). This retrospective descriptive research aimed to study clinical outcomes of KD at Buddhachinaraj Phitsanulok hospital from 1 January 2010 to 31 December 2014. The results showed that 67 patients were diagnosis as KD, 34 (50.7%) complete KD and 33 (49.3%) incomplete KD. Average ages of patients were 2.39 ± 1.79 (range 0.2-7.5) years, and the male/female ratio was 1:1.1. In 22 patients (32.8%) had respiratory tract infection and 21 patients (31.3%) had diarrhea. Incomplete KD were diagnosed by laboratory criteria (87.9%) and echo criteria (12.1%). The laboratory criteria were anemia (93.1%), high WBC count (86.2%), high platelet count (65.5%), WBC in urine (45.5%), high alanine aminotransferase (36.4%) and low serum albumin (6.1%). High dose intravenous immunoglobulin (IVIG) treatments were effective in 66 of 67 patients (98.5%). 14 patients (20.9%) had coronary aneurysm at diagnosis. After 6-8 weeks follow up, only six patients (9%) had coronary aneurysm. Only one patient (1.5%) still had coronary aneurysm at one year. The CAA cases showed association with incomplete KD (p = 0.043) and had longer time from onset of disease to IVIG treatment (p = 0.026). Thus, the clinical outcomes of Kawasaki disease in children depend on the manifestation of complete or incomplete Kawasaki and the time from the onset of fever to administration of IVIG.