Describing Kawasaki shock syndrome: results from a retrospective study and literature review
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- 作者：Andrea Taddio ; Eleonora Dei Rossi ; Lorenzo Monasta ; Serena Pastore…
- 关键词：Coronary artery involvement ; Heart failure ; Hypotension ; Kawasaki disease ; Kawasaki shock syndrome
- 刊名：Clinical Rheumatology
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：36
- 期：1
- 页码：223-228
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Rheumatology;
- 出版者：Springer London
- ISSN：1434-9949
- 卷排序：36
文摘
Kawasaki shock syndrome (KSS) is a rare manifestation of Kawasaki disease (KD) characterized by systolic hypotension or clinical signs of poor perfusion. The objectives of the study are to describe the main clinical presentation, echocardiographic, and laboratory findings, as well as the treatment options and clinical outcomes of KSS patients when compared with KD patients. This is a retrospective study. All children referred to two pediatric rheumatology units from January 1, 2012, to December 31, 2014, were enrolled. Patients were divided into patients with or without KSS. We compared the two groups according to the following variables: sex, age, type of KD (classic, with less frequent manifestations, or incomplete), clinical manifestations, cardiac involvement, laboratory findings, therapy administered, response to treatment, and outcome. Eighty-four patients with KD were enrolled. Of these, five (6 %) met the criteria for KSS. Patients with KSS had higher values of C-reactive protein (p = 0.005), lower hemoglobin levels (p = 0.003); more frequent hyponatremia (p = 0.004), hypoalbuminemia (p = 0.004), and coagulopathy (p = 0.003); and increase in cardiac troponins (p = 0.000). Among the KSS patients, three had a coronary artery involvement, but none developed a permanent aneurysm. Intravenous immunoglobulin resistance was more frequent in the KSS group, although not significantly so (3/5, 60 % vs. 23/79, 30 %, P = NS). None of the five cases was fatal, and all recovered without sequelae. KSS patients are more likely to have higher rates of cardiac involvement. However, most cardiovascular abnormalities resolved promptly with therapy.