Clinical features of children with recurrent Kawasaki disease: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with recurrent Kawasaki disease (KD).@*METHODS@#PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, and Weipu Data were searched for case-control studies on the clinical features of initial and recurrent KD. The articles were screened according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the Meta analysis. Effect models were selected based on the results of heterogeneity test, and then pooled @*RESULTS@#A total of 9 case-control studies were included, with 12 059 children with KD in total, among whom 206 children had recurrent KD (127 boys/61.7%; 79 girls/38.3%). The results of the Meta analysis showed that compared with the initial KD onset, the children with recurrent KD had a shorter duration of fever (@*CONCLUSIONS@#Current evidence shows that children with recurrent KD tend to have a shorter duration of fever and a lower incidence of swelling of the hands and feet. KD recurrence is more common in boys. Current evidence does not show an increased risk of developing coronary artery lesions in children with recurrent KD.

Lipidomic Profiling of Mastoid Bone and Tissue from Patients with Chronic Otomastoiditis

Introduction Chronic otomastoiditis causes pain, otorrhea, and hearing loss resulting from the growth of tissue within the normally hollow mastoid cavity. Objectives In this report, we used a lipidomics approach to profile major mastoid bone and tissue lipids from patients with and without otomastoiditis. Methods The bone dust created during mastoidectomy, as well as the mastoid tissue, was analyzed from seven patients. Bone dust was also collected and analyzed in an additional four otologic cases (parotidectomy requiring mastoidectomy). Samples were subjected to a modified Bligh/Dyer lipid extraction, then high-performance thin-layer chromatography (HPTLC), combined gas chromatography/electron impact-mass spectrometry (GC/EI-MS), and flow-injection/electrospray ionization-tandem mass spectrometry (FI/ESI-MSMS). Data were analyzed for identification and profiling of major lipid components. Results HPTLC revealed the presence of various lipid classes, including phosphatidylcholines, cholesterol, and triacylglycerols. GC/EI-MS analysis revealed the presence of cholesterol and several fatty acids. FI/ESI-MSMS analysis revealed a host of phosphatidylcholines, phosphatidylethanolamines, and cholesteryl esters. Conclusion We used a lipidomics approach to develop an efficient (both in time and tissue amount) methodology for analysis of these tissues, identify the most abundant and common lipid species, and create a base of knowledge from which more focused endeavors in biomarker discovery can emerge. In an effort toward improved patient categorization and individualized intervention, the ultimate goal of this work is to correlate these lipid molecules to disease state and progression. This is the first reported study of its kind on these tissues. .

Enfermedad de Kawasaki. Revisión de la literatura / Kawasaki Disease: a Review of the Literature

La Enfermedad de Kawasaki (EK) es una vasculitis sistémica febril, con predilección por las arterias de pequeño y mediano calibre, cuya complicación más frecuente es la dilatación aneurismática de las arterias coronarias. Actualmente es la primera causa de cardiopatía adquirida en la infancia en los países desarrollados. El propósito de esta revisión es conocer las características clínicas y las posibles formas de presentación de esta patología, además del tratamiento actual .

Kawasaki disease (KD) is a febrile typeof systemic vasculitis with a predilectionfor small-and medium-sized arteries.The most frequent complication is aneuritic coronary artery dilation. It is currently the most common cause of acquired cardiopathy in childhood in developed countries. The purposeof this review is to high light the clinical...

Endothelial function in pre-pubertal children at risk of developing cardiomyopathy: a new frontier

Although it is known that obesity, diabetes, and Kawasaki's disease play important roles in systemic inflammation and in the development of both endothelial dysfunction and cardiomyopathy, there is a lack of data regarding the endothelial function of pre-pubertal children suffering from cardiomyopathy. In this study, we performed a systematic review of the literature on pre-pubertal children at risk of developing cardiomyopathy to assess the endothelial function of pre-pubertal children at risk of developing cardiomyopathy. We searched the published literature indexed in PubMed, Bireme and SciELO using the keywords 'endothelial', 'children', 'pediatric' and 'infant' and then compiled a systematic review. The end points were age, the pubertal stage, sex differences, the method used for the endothelial evaluation and the endothelial values themselves. No studies on children with cardiomyopathy were found. Only 11 papers were selected for our complete analysis, where these included reports on the flow-mediated percentage dilatation, the values of which were 9.80±1.80, 5.90±1.29, 4.50±0.70, and 7.10±1.27 for healthy, obese, diabetic and pre-pubertal children with Kawasaki's disease, respectively. There was no significant difference in the dilatation, independent of the endothelium, either among the groups or between the genders for both of the measurements in children; similar results have been found in adolescents and adults. The endothelial function in cardiomyopathic children remains unclear because of the lack of data; nevertheless, the known dysfunctions in children with obesity, type 1 diabetes and Kawasaki's disease may influence the severity of the cardiovascular symptoms, the prognosis, and the mortality rate. The results of this study encourage future research into the consequences of endothelial dysfunction in pre-pubertal children.

Clinical characteristics of kawasaki disease according to age at diagnosis.

Objective: We compared the clinical, laboratory and diagnostic features of Kawasaki disease (KD) in children £6 mo and ³5 y of age to those in the more typical age range at diagnosis (6 mo-5 y of age). Study design: Retrospective analysis. Setting: Severeance Children Hospital attached to a Medical School, Korea. Methods: All children with a discharge diagnosis of KD at Severance Children’s Hospital (2006-2007) were retro-spectively reviewed and grouped according to age at presentation in 3 groups: <6 mo, 6 mo-5 y and ³5 years. Clinical, hematological, and biochemical features and involvement of coronary artery and proportion of Classic vs. Incomplete KD were compared between the 3 groups. Results: A total of 185 children were identified. Complete KD was found in 63 (34%) children and Incomplete KD in 122 (66%). There was 22(12%) children below 6 months of age, 131 (71%) between 6 months to 5 years) and 32 (17%) above 5 years of age. Clinical, hematological and biochemical features were comparable between the three age groups. Overall, coronary artery lesions occurred in 9% children without any preference for age. The proportion of Classical vs. Incomplete KD was also similar in the three age categories. Conclusion: The clinical and laboratory phenotype of KD does not vary significantly with age.

Síndrome de Kawasaki: a propósito de un infante con meningitis aséptica y cambios en la cicatriz de BCG / Kawasaki syndrome: a child with aseptic meningitis and changes at BCG scar site

Presentamos el caso de un niño de 12 meses de edad referido al Hospital Nacional de Niños con diagnóstico presuntivo de exantema súbito, meningitis aséptica y choque incipiente. El paciente se ingresa, tras múltiples consultas a un hospital periférico, al día 14 de fiebre como síntoma más importante. A su ingreso se documentó meningitis aséptica, induración y enrojecimiento en el sitio de aplicación de la vacuna de la BCG, aparte de los criterios clásicos para Síndrome de Kawasaki. El ecocardiograma inicial mostró dilatación coronaria. El Síndrome de Kawasaki debe formar parte del diagnóstico diferencial del infante y niño con enfermedad eruptiva febril, y debe tenerse un alto índice de sospecha clínica de esta entidad

Enfermedad de Kawasaki y fenómeno de Raynaud en un paciente de 15 años de edad

La enfermedad de Kawasaki es una síndrome febril agudo acompañado por inyección conjuntival, exantema polimorfo, eritema e induración en manos, afección de la mucosa oral y linfadenopatías cervicales. Durante la fase de convalecencia se presenta descamación en palmas y plantas. Aunque esta entidad se manifiesta principalmente en niños menores de cinco años, también ha sido descrita en otros grupos etáreos. Describimos el caso de un individuo de 15 años de edad que cumple con todos los criterios diagnósticos y que tiene además la particularidad de presentar un fenomeno de Raynaud como manifestación asociada. Fue manjeado con gammaglobulina endovenosa y aspirina. No se identificaron complicaciones cardiovasculares. Es el primer caso descrito en un adolescente colombiano y el tercero informado en nuestra literatura.

Enfermedad de Kawasaki: aspectos clínicos-epidemiológicos / Kawasaki's diseases: clinical and epidemiological aspect

Se revisan todos aquellos aspectos clínico-epidemiológicos que tienen trascendencia con el síndrome linfomucocutáneo o enfermedad de Kawasaki. La significación de quellos procesos infecciosos o inmunológicos en la patogenia del cuadro son revisados en base a la literatura