Xi Chen, Lu Gao, Zhen Zhen, Ying Wang, Jia Na, Wen Yu, Zhiyu Tian, Yue Yuan, Suyun Qian
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引用次数: 0
摘要
目的：冠状动脉病变（CAL）是川崎病（KD）的主要并发症：冠状动脉病变（CAL）是川崎病（KD）的主要并发症，然而，有关复发性KD的CAL发生率和风险因素的数据却很有限。方法：从2013年至2022年，97名复发性KD患儿接受了回顾性登记，并在入院、出院和随访期间追踪CAL发生率：最初，27.8%的儿童在入院和出院时有CAL，出院后12个月时降至7.2%。大多数患者（97 例中的 66 例，68.0%）在任何时间点均未出现 CAL，7 例在所有时间点均出现 CAL，表明 CAL 持续存在。其余 20 例患者在入院时出现 CAL，但在出院时或随访期间恢复。值得注意的是，一过性 CAL 在出院时或随访期间出现，但最终在出院后 12 个月时消失。值得注意的是，之前的 IVIG 抗药性和凝血酶原时间延长似乎与复发性 KD 的 CAL 有关，这表明它们有助于识别需要密切监测的患者。结论：该研究强调，随着时间的推移，复发性 KD 中的 CAL 发生率在下降，但模式各不相同，因此强调了监测和进一步调查以证实这些发现的重要性。
Incidence of coronary artery lesions in children with recurrent Kawasaki disease.
Objective: Coronary artery lesions (CALs) are a major complication of Kawasaki disease (KD); however, data on CAL incidence and risk factors in recurrent KD are limited.
Methods: Ninety-seven children with recurrent KD were retrospectively enrolled from 2013 to 2022, and CAL incidence was tracked during admission, discharge, and during follow-up.
Results: Initially, 27.8% had CAL at admission and discharge, declining to 7.2% at 12 months post-discharge. Most patients (66 of 97, 68.0%) did not exhibit CAL at any of the time points, 7 cases presented CAL at all time points, indicating a persistent CAL. The remaining 20 cases presented CAL at admission but recovered at discharge or during follow-up. Notably, transient CALs had presented at discharge, or during the follow-up, but finally resolved at 12 months after discharge. Notably, prior IVIG resistance and increased prothrombin time seemed associated with CAL in recurrent KD, suggesting they could help identify patients needing close monitoring.
Conclusion: The study highlights decreasing CAL incidence over time in recurrent KD but with diverse patterns, emphasizing the importance of monitoring and further investigations to confirm these findings.
期刊介绍：
Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology.
Articles focus on the following key areas:
• Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines
• Performance and benefits of newly approved therapeutic agents
• New diagnostic approaches
• Screening and patient stratification
• Pharmacoeconomic studies
• New therapeutic indications for existing therapies
• Adverse effects, occurrence and reduction
• Prospects for medicines in late-stage trials approaching regulatory approval
• Novel treatment strategies
• Epidemiological studies
• Commentary and comparison of treatment guidelines
Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.
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