6:15 PM - 7:15 PM
[II-JCKP2-02] Shock as prominent early manifestation of kawasaki disease in Children
OBJECTIVEWe sought to define the characteristics that distinguish Kawasaki diseaseshock syndrome (KDSS)from hemodynamically normal Kawasaki disease. METHODSWe collected data prospectively for all patients with Kawasaki disease whowere treated at a single institution during a 2-year period. We compared clinical and laboratory features, coronary artery measurements,and responses to therapy and analyzed indices of ventricular systolic anddiastolic function during acute and convalescent Kawasaki disease.
RESULTS Of 231 consecutive patients with Kawasaki disease, 4 met the definitionfor KDSS. All required fluid resuscitation and vasoactive infusions. Compared with patients without shock, patientswith Kawasaki disease shock syndrome were more often female,the age of patientswith KDSS was between 5.2 to 8.9 years, as well as had largerproportions of bands, higher C-reactive protein concentrations, and lower hemoglobinconcentrations and platelet counts. Evidence of consumptive coagulopathy wascommon in the KDSS group. Patients with KDSS more often had impaired left ventricular systolic function, mitralregurgitation , coronary arteryabnormalities, and intravenous immunoglobulin resistance . Impairment of ventricular relaxation and compliance persistedamong patients with KDSS after the resolution of other hemodynamic disturbances.
CONCLUSIONSPatients with KDSS may have uneven clinical course and may be misdiagnosed in thebeginning. They may have more prominent inflammatory markers in the early phase and higherrisk of coronary artery dilatation.
RESULTS Of 231 consecutive patients with Kawasaki disease, 4 met the definitionfor KDSS. All required fluid resuscitation and vasoactive infusions. Compared with patients without shock, patientswith Kawasaki disease shock syndrome were more often female,the age of patientswith KDSS was between 5.2 to 8.9 years, as well as had largerproportions of bands, higher C-reactive protein concentrations, and lower hemoglobinconcentrations and platelet counts. Evidence of consumptive coagulopathy wascommon in the KDSS group. Patients with KDSS more often had impaired left ventricular systolic function, mitralregurgitation , coronary arteryabnormalities, and intravenous immunoglobulin resistance . Impairment of ventricular relaxation and compliance persistedamong patients with KDSS after the resolution of other hemodynamic disturbances.
CONCLUSIONSPatients with KDSS may have uneven clinical course and may be misdiagnosed in thebeginning. They may have more prominent inflammatory markers in the early phase and higherrisk of coronary artery dilatation.