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Cardiac Involvement and Risk Factors in Kawasaki Disease

الاختلاطات القلبية في داء كاوازاكي، عوامل الخطورة، الإنذار

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 Publication date 1986
and research's language is العربية
 Created by Shamra Editor




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Background& Objective: Kawasaki disease is a generalized vasculitis of unknown etiology which causes coronary artery abnormalities in 20-25 percent of untreated children. The aim of this study was to determine the type of heart lesion and the coronary risk factors and to identify patients with high risk in order to take the necessary measures to reduces morbidity and morbidity. Materials & Methods: We studied 70 children, aged 3 month to 10 years, who met the criteria for the diagnosis of KD, two thirds were males. Results: Of the (70) children who had KD , 15 cases (21.4 %) had coronary artery abnormalities ,12 cases (17 %) had pericarditis, and 7 cases (10 %) had mitral regurgitation .The coronary artery abnormalities were classified as follows: diffuse ectasia (5) cases 33.3%, coronary artery aneurysms 10 cases (66.6%). small to medium-sized coronary artery aneurysms (6) cases, large sized coronary artery aneurysms (2) cases, and giant aneurysms in (2) cases . The risk factors for coronary aneurysms were age less than 1 year or more than 5 years, male gender, fever lasting more than 10 days or recurrence of fever after an a febrile period, lower hemoglobin, lower platelet count, higher white cell count , lower albumin level and pericarditis. Echocardiogram follow up studied indicate coronary artery aneurysms resolve within 5 to 31 months in approximately 60% of patients where (6) aneurysms regressed spontaneously and the two large aneurysms became smaller. One patient with giant aneurysm had developed coronary stenosis and needed a coronary bypass surgery at the age of 9 years. Conclusion: Coronary aneurysms were the predominant cardiac lesions in our series, most of these aneurysms were resolved at follow up of 2-3 years.


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Research summary
تناول البحث دراسة داء كاوازاكي، وهو التهاب أوعية حاد مجهول السبب يصيب الأطفال، ويؤدي إلى إصابات في الشرايين الإكليلية بنسبة 20-25% من الأطفال غير المعالجين. هدفت الدراسة إلى تحديد نمط الإصابات القلبية وعوامل الخطورة المرتبطة بها، وذلك من خلال دراسة 70 طفلاً تتراوح أعمارهم بين 3 شهور و10 سنوات، حيث شكل الذكور نحو ثلثي الحالات. أظهرت النتائج أن 21.4% من الأطفال المصابين بداء كاوازاكي يعانون من إصابات في الشرايين الإكليلية، و17% يعانون من التهاب التأمور، و10% يعانون من قصور تاجي. تم تصنيف الإصابات الإكليلية إلى توسع عابر وأمهات الدم بأحجام مختلفة. عوامل الخطورة تضمنت العمر أقل من سنة أو أكثر من 5 سنوات، الجنس الذكري، الحمى المستمرة لأكثر من 10 أيام، انخفاض خضاب الدم، انخفاض تعداد الصفيحات الدموية، ارتفاع تعداد الكريات البيض، انخفاض ألبومين المصل، والتهاب التأمور. أظهرت المتابعة بتصوير صدى القلب تراجع أمهات الدم بشكل عفوي في نحو 60% من الحالات خلال مدة راوحت بين 5 و31 شهراً. خلصت الدراسة إلى أن أمهات الدم الإكليلية كانت الإصابة القلبية الأكثر شيوعاً، وأن معظمها تراجعت بشكل عفوي خلال فترة المتابعة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة في تسليط الضوء على داء كاوازاكي وعلاقته بالإصابات القلبية وعوامل الخطورة المرتبطة به. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة قد يكون غير كافٍ لتعميم النتائج على جميع الأطفال المصابين بداء كاوازاكي. ثانياً، لم يتم تناول العوامل الوراثية أو البيئية التي قد تسهم في تطور المرض. ثالثاً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تم تضمين متغيرات إضافية مثل العوامل الغذائية أو الاجتماعية. وأخيراً، كان من الأفضل توضيح المزيد من التفاصيل حول الإجراءات العلاجية المستخدمة وكيفية تأثيرها على النتائج النهائية.
Questions related to the research
  1. ما هو داء كاوازاكي؟

    داء كاوازاكي هو التهاب أوعية حاد مجهول السبب يصيب الأطفال، ويؤدي إلى إصابات في الشرايين الإكليلية بنسبة 20-25% من الأطفال غير المعالجين.

  2. ما هي عوامل الخطورة المرتبطة بالإصابات الإكليلية في داء كاوازاكي؟

    تشمل عوامل الخطورة العمر أقل من سنة أو أكثر من 5 سنوات، الجنس الذكري، الحمى المستمرة لأكثر من 10 أيام، انخفاض خضاب الدم، انخفاض تعداد الصفيحات الدموية، ارتفاع تعداد الكريات البيض، انخفاض ألبومين المصل، والتهاب التأمور.

  3. كيف تم تصنيف الإصابات الإكليلية في الدراسة؟

    تم تصنيف الإصابات الإكليلية إلى توسع عابر وأمهات الدم بأحجام مختلفة: صغيرة-متوسطة، كبيرة، وعرطلة.

  4. ما هي نسبة الأطفال الذين يعانون من إصابات في الشرايين الإكليلية في الدراسة؟

    بلغت نسبة الأطفال الذين يعانون من إصابات في الشرايين الإكليلية 21.4% من الأطفال المصابين بداء كاوازاكي.


References used
Rosenfeld EA, Corydon KE, Shulman ST. Kawasaki disease in infants less than one year of age. J Pediatr. 1995; 126: 524–529
Baer AZ, Rubin LG, Shapiro CA, Sood SK, Rajan S, Shapir Y. Prevalence of coronary artery lesions on the initial echocardiogram in Kawasaki syndrome. Arch Pediatr Adolesc Med. 2006; 160: 686–690
Tse SM, Silverman ED, McCrindle BW, Yeung RS. Early treatment with intravenous immunoglobulin in patients with Kawasaki disease. J Pediatr. 2002; 140: 450–455
Sawaji Y, Haneda N, Yamaguchi S, Kajino Y, Kishida K, Seto S, Konishi N,. Coronary risk factors in acute Kawasaki disease: correlation of serum immunoglobulin levels with coronary complications. Acta Paediatr Jpn. 1998; 40: 218–225
Brian W. McCrindle, MD, MPH; Jennifer S. Li, MD; L. LuAnn Minich, MD; Coronary Artery Involvement in Children With Kawasaki Disease Risk Factors From Analysis of Serial Normalized Measurements Circulation. 2007; 116: 174-179
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