Araştırma Makalesi
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Relationship Between Kawasaki Syndrome and Viral Infection

Yıl 2022, Cilt: 8 Sayı: 1, 98 - 105, 25.02.2022
https://doi.org/10.19127/mbsjohs.1038969

Öz

Objective: This study aimed to investigate the relationship between Kawasaki syndrome and viral infections.
Methods: The data of the Kawasaki syndrome cases diagnosed between January 2017 to December 2019 were reviewed from hospital records retrospectively.
Results: Among eighteen cases ten were boys, and eight were girls. Their average age at diagnosis was 38.28 ± 28.38 (3-113 months). Seven cases were in winter, eight in spring and autumn, and three in summer diagnosed. The mean length of stay in the hospital was 7.41±3.34 (3-17 days). All patients presented with fever, and the mean duration of fever was 6.94 ± 1.63 days. Six cases were classified as typical KS (33.3%), and twelve as atypical KS (66.7%). Laboratory examinations revealed a leukocyte count of 16507 ± 61817 /mm³, C-reactive protein 8.59 ±5.87 mg/dl, erythrocyte sedimentation rate (ESR) median value 58 mm/hour (18-102). Fourteen patients had cardiac involvement (pericardial effusion, mitral insufficiency), and six had small coronary artery involvement. Both cardiac and coronary artery involvement rates were higher in the atypical KS. In only six cases (33.3%) were the pathogens detected. The detected infectious agents were: Parainfluenza type 4, Parainfluenza type 3, Respiratory syncytial virus, Group A streptococcus, Epstein-Barr virus, Ochrobactrumanthropi, Rubella, Cytomegalovirus.
Conclusion: Detection of infectious agents in only one-third of the cases and the presence of different factors suggest that the Kawasaki syndrome is not related to a specific pathogenic agent. Coronary involvement was not found to be associated with pathogenic agents. However, atypical KS needs more attention for cardiac involvement.

Kaynakça

  • 1. Weng KP, Hsieh KS, Hwang YT, Huang SH, Lai TJ, Yeong-Seng Yuh, et al. IL-10 polymorphisms are associated with coronary artery lesions in acute stage of Kawasaki disease. Circ J. 2010;74:983-989.
  • 2. Weng KP, Hsieh KS, Ho TY, Huang SH, Lai CR, Chiu YT, et al. IL-1B polymorphism in association with initial IVIG treatment failure in Taiwanese children with Kawasaki disease. Circ J. 2010;74:544-551.
  • 3. Takatsuki S, Ito Y, Takeuchi D, Hoshida H, Nakayama T, Matsuura H, et al. IVIG reduced vascular oxidative stress in patients with Kawasaki disease. Circ J. 2009;73:1315-1318.
  • 4. Chang LY, Chang IS, Lu CY, Chiang BL, Lee CY, Chen PJ, et al. Epidemiological features of Kawasaki disease in Taiwan from 1996 to 2002. Pediatrics. 2004;114:e678-682.
  • 5. Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodó X, Uehara R, et al. Seasonality of Kawasaki disease: a global perspective. PLoS One. 2013;8:e74529.
  • 6. Sano T, Makino N, Aoyama Y, Kojo T, Kotani K, Kotani K, et al. Temporal and geographical clustering of Kawasaki disease in Japan (2007-2012). Pediatr Int. 2016;58:1140-1145.
  • 7. Chang LY, Lu CY, Shao PL, Lee PI, Lin MT, Fan TY, et al. Viral infections associated with Kawasaki disease. J Formos Med Assoc. 2014;113:148-154.
  • 8. Chen S, Dong Y, Kiuchi M, Wang J, Li R, Ling Z, et al. Coronary artery complication in Kawasaki disease and the importance of early intervention. JAMA Pediatr. 2016;170(12):1156-1163.
  • 9. McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientic statement for health professionals from the American heart association. Circulation. 2017;135:e927-99.
  • 10. Lin, MC, Lai, MS, Jan, SL, Fu, YC J Chinese Med Assoc. Vol. 78. Elsevier Taiwan LLC and the Chinese Medical Association; 2015. Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997-2010: Effect of different case definitions in claims data analysis; p. 121-6. Internet Available from: http://dx.doi.org/10.1016/j.jcma.2014.03.009.
  • 11. Singh S, Vignesh P, Burgner D. The epidemiology of Kawasaki disease: a global update. Arch Dis Child. 2015;100(11):1084–8.
  • 12. Chang RK. Hospitalizations for Kawasaki disease among children in the United States, 1988–1997. Pediatrics. 2002;109:e87.
  • 13. Principi N, Rigante D, Esposito S. The role of infection in Kawasaki syndrome. J Infect. 2013;67:1–10.
  • 14. Kikuta H, Matsumoto S, Yanase Y, Kawasaki T, Mizuno F, Osato T.Recurrence of Kawasaki disease and Epstein-Barr virus infection. J Infect Dis. 1990;162:1215.
  • 15. Makino N, Nakamura Y, Yashiro M, Sano T, Ae R, Kosami K, et al Epidemiological observations of Kawasaki disease in Japan, 2013-2014.Pediatr Int. 2018;60:581–7.
  • 16. Kim GB, Han JW, Park YW, Song MS, Hong YM, Cha SH, et al. Epidemiologic features of Kawasaki disease in South Korea: data from nationwide survey, 2009-2011. Pediatr Infect Dis J. 2014;33:24–7.
  • 17. Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, et al.Childhood vasculitis in Turkey: a nationwide survey. Clin Rheumatol. 2007;26:196-200.
  • 18. De La Harpe M, Di Bernardo S, Hofer M, Sekarski N. Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne. Front Pediatr. 2019;30;7:11.
  • 19. Maggio MC, Cimaz R, Alaimo A, Comparato C, Di Lis D. and Corsello G. Kawasaki disease triggered by parvovirus infection: an atypical case report of two siblings. Journal of Medical Case Reports 2019;13:104.
  • 20. Jaggi P, Kajon AE, Mejias A, Ramilo O, Leber A. Human adenovirus infection in Kawasaki disease a confounding bystander? Clin. Infect. Dis. 2013;56,58-64.
  • 21. Turnier JL, Anderson MS, Heizer HR, Jone PN, Glode MP, Dominguez SR. Concurrent Respiratory Viruses and Kawasaki Disease. Pediatrics 2015;136,609-614.

The Relationship Between Kawasaki Syndrome and Viral Infections

Yıl 2022, Cilt: 8 Sayı: 1, 98 - 105, 25.02.2022
https://doi.org/10.19127/mbsjohs.1038969

Öz

Objective: This study aimed to investigate the relationship between Kawasaki syndrome and viral infections.
Methods: The data of the Kawasaki syndrome cases diagnosed between January 2017 to December 2019 were reviewed from hospital records retrospectively.
Results: Among eighteen cases ten were boys, and eight were girls. Their average age at diagnosis was 38.28 ± 28.38 (3-113 months). Seven cases were in winter, eight in spring and autumn, and three in summer diagnosed. The mean length of stay in the hospital was 7.41±3.34 (3-17 days). All patients presented with fever, and the mean duration of fever was 6.94 ± 1.63 days. Six cases were classified as typical KS (33.3%), and twelve as atypical KS (66.7%). Laboratory examinations revealed a leukocyte count of 16507 ± 61817 /mm³, C-reactive protein 8.59 ±5.87 mg/dl, erythrocyte sedimentation rate (ESR) median value 58 mm/hour (18-102). Fourteen patients had cardiac involvement (pericardial effusion, mitral insufficiency), and six had small coronary artery involvement. Both cardiac and coronary artery involvement rates were higher in the atypical KS. In only six cases (33.3%) were the pathogens detected. The detected infectious agents were: Parainfluenza type 4, Parainfluenza type 3, Respiratory syncytial virus, Group A streptococcus, Epstein-Barr virus, Ochrobactrumanthropi, Rubella, Cytomegalovirus.
Conclusion: Detection of infectious agents in only one-third of the cases and the presence of different factors suggest that the Kawasaki syndrome is not related to a specific pathogenic agent. Coronary involvement was not found to be associated with pathogenic agents. However, atypical KS needs more attention for cardiac involvement.

Kaynakça

  • 1. Weng KP, Hsieh KS, Hwang YT, Huang SH, Lai TJ, Yeong-Seng Yuh, et al. IL-10 polymorphisms are associated with coronary artery lesions in acute stage of Kawasaki disease. Circ J. 2010;74:983-989.
  • 2. Weng KP, Hsieh KS, Ho TY, Huang SH, Lai CR, Chiu YT, et al. IL-1B polymorphism in association with initial IVIG treatment failure in Taiwanese children with Kawasaki disease. Circ J. 2010;74:544-551.
  • 3. Takatsuki S, Ito Y, Takeuchi D, Hoshida H, Nakayama T, Matsuura H, et al. IVIG reduced vascular oxidative stress in patients with Kawasaki disease. Circ J. 2009;73:1315-1318.
  • 4. Chang LY, Chang IS, Lu CY, Chiang BL, Lee CY, Chen PJ, et al. Epidemiological features of Kawasaki disease in Taiwan from 1996 to 2002. Pediatrics. 2004;114:e678-682.
  • 5. Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodó X, Uehara R, et al. Seasonality of Kawasaki disease: a global perspective. PLoS One. 2013;8:e74529.
  • 6. Sano T, Makino N, Aoyama Y, Kojo T, Kotani K, Kotani K, et al. Temporal and geographical clustering of Kawasaki disease in Japan (2007-2012). Pediatr Int. 2016;58:1140-1145.
  • 7. Chang LY, Lu CY, Shao PL, Lee PI, Lin MT, Fan TY, et al. Viral infections associated with Kawasaki disease. J Formos Med Assoc. 2014;113:148-154.
  • 8. Chen S, Dong Y, Kiuchi M, Wang J, Li R, Ling Z, et al. Coronary artery complication in Kawasaki disease and the importance of early intervention. JAMA Pediatr. 2016;170(12):1156-1163.
  • 9. McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientic statement for health professionals from the American heart association. Circulation. 2017;135:e927-99.
  • 10. Lin, MC, Lai, MS, Jan, SL, Fu, YC J Chinese Med Assoc. Vol. 78. Elsevier Taiwan LLC and the Chinese Medical Association; 2015. Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997-2010: Effect of different case definitions in claims data analysis; p. 121-6. Internet Available from: http://dx.doi.org/10.1016/j.jcma.2014.03.009.
  • 11. Singh S, Vignesh P, Burgner D. The epidemiology of Kawasaki disease: a global update. Arch Dis Child. 2015;100(11):1084–8.
  • 12. Chang RK. Hospitalizations for Kawasaki disease among children in the United States, 1988–1997. Pediatrics. 2002;109:e87.
  • 13. Principi N, Rigante D, Esposito S. The role of infection in Kawasaki syndrome. J Infect. 2013;67:1–10.
  • 14. Kikuta H, Matsumoto S, Yanase Y, Kawasaki T, Mizuno F, Osato T.Recurrence of Kawasaki disease and Epstein-Barr virus infection. J Infect Dis. 1990;162:1215.
  • 15. Makino N, Nakamura Y, Yashiro M, Sano T, Ae R, Kosami K, et al Epidemiological observations of Kawasaki disease in Japan, 2013-2014.Pediatr Int. 2018;60:581–7.
  • 16. Kim GB, Han JW, Park YW, Song MS, Hong YM, Cha SH, et al. Epidemiologic features of Kawasaki disease in South Korea: data from nationwide survey, 2009-2011. Pediatr Infect Dis J. 2014;33:24–7.
  • 17. Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, et al.Childhood vasculitis in Turkey: a nationwide survey. Clin Rheumatol. 2007;26:196-200.
  • 18. De La Harpe M, Di Bernardo S, Hofer M, Sekarski N. Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne. Front Pediatr. 2019;30;7:11.
  • 19. Maggio MC, Cimaz R, Alaimo A, Comparato C, Di Lis D. and Corsello G. Kawasaki disease triggered by parvovirus infection: an atypical case report of two siblings. Journal of Medical Case Reports 2019;13:104.
  • 20. Jaggi P, Kajon AE, Mejias A, Ramilo O, Leber A. Human adenovirus infection in Kawasaki disease a confounding bystander? Clin. Infect. Dis. 2013;56,58-64.
  • 21. Turnier JL, Anderson MS, Heizer HR, Jone PN, Glode MP, Dominguez SR. Concurrent Respiratory Viruses and Kawasaki Disease. Pediatrics 2015;136,609-614.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Ceren Yapar Gümüş 0000-0001-6349-2514

Nurdan Erol 0000-0002-9650-2077

Nihan Uygur Külcü 0000-0001-8771-5292

Yayımlanma Tarihi 25 Şubat 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 8 Sayı: 1

Kaynak Göster

Vancouver Yapar Gümüş C, Erol N, Uygur Külcü N. Relationship Between Kawasaki Syndrome and Viral Infection. Mid Blac Sea J Health Sci. 2022;8(1):98-105.

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