Complicações da Doença de Kawasaki: estudo retrospectivo em hospital terciário de Brasília
DOI:
https://doi.org/10.34119/bjhrv7n4-186Keywords:
doença de Kawasaki, complicações, vasculite, pediatriaAbstract
Introdução: A Doença de Kawasaki (DK) é uma vasculite sistêmica de etiologia desconhecida que acomete vasos de pequeno e médio calibres, podendo resultar em complicações em diversos sistemas do corpo. Objetivos: Avaliar as complicações da DK e identificar seus possíveis fatores de risco. Metodologia: Trata-se de uma coorte clínica retrospectiva através da análise de prontuários de pacientes diagnosticados com DK, acompanhados em Serviço de Reumatologia em hospital terciário entre 2017 e 2019. Resultados: Foram incluídos 61 pacientes, com complicações em 39 (63,93%) deles. Foram observadas complicações cardiovasculares (45,90%), comportamentais (21,31%), neurológicas (4,91%), gastrointestinais (3,28%), respiratórias (3,28%) e urinárias (1,64%). Conclusão: A prevalência de complicações encontrada foi superior a estudos prévios, provavelmente pelo acompanhamento regular e a longo prazo realizado com protocolo padronizado. Não foram identificados fatores de risco para ocorrência de complicações da DK.
References
Newburger JW, Takahashi M, Burns JC. Kawasaki Disease. J Am Coll Cardiol. 2016 Apr 12;67(14):1738-49. doi: 10.1016/j.jacc.2015.12.073. PMID: 27056781.
Makino N, Nakamura Y, Yashiro M, Sano T, Ae R, Kosami K, Kojo T, Aoyama Y, Kotani K, Yanagawa H. Epidemiological observations of Kawasaki disease in Japan, 2013-2014. Pediatr Int. 2018 Jun;60(6):581-587. doi: 10.1111/ped.13544. PMID: 29498791.
Manlhiot C, Yeung RS, Clarizia NA, Chahal N, McCrindle BW. Kawasaki disease at the extremes of the age spectrum. Pediatrics. 2009 Sep;124(3):e410-5. doi: 10.1542/peds.2009-0099. Epub 2009 Aug 24. PMID: 19706564.
McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 2017 Apr 25;135(17).
Rowley AH, Shulman ST. The Epidemiology and Pathogenesis of Kawasaki Disease. Front Pediatr. 2018 Dec 11;6:374. doi: 10.3389/fped.2018.00374. PMID: 30619784; PMCID: PMC6298241.
Orenstein JM, Shulman ST, Fox LM, Baker SC, Takahashi M, Bhatti TR, Russo PA, Mierau GW, de Chadarévian JP, Perlman EJ, Trevenen C, Rotta AT, Kalelkar MB, Rowley AH. Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study. PLoS One. 2012;7(6):e38998. doi: 10.1371/journal.pone.0038998. Epub 2012 Jun 18. PMID: 22723916; PMCID: PMC3377625.
Suzuki A, Miyagawa-Tomita S, Nakazawa M, Yutani C. Remodeling of coronary artery lesions due to Kawasaki disease: comparison of arteriographic and immunohistochemical findings. Jpn Heart J. 2000 May;41(3):245-56. doi: 10.1536/jhj.41.245. PMID: 10987345.
Dionne A, Dahdah N. Myocarditis and Kawasaki disease. Int J Rheum Dis. 2018 Jan;21(1):45-49. doi: 10.1111/1756-185X.13219. Epub 2017 Nov 3. PMID: 29105303.
Medeiros R de Magalhães C, Coutinho de Almeida F, Gandolfi L, Pratesi R, Ribeiro de M Alves N, Selleski N, Zandonadi RP, Nakano EY, Pratesi CB. Clinical Manifestations of Kawasaki Disease at Different Age Spectrum: A Ten-Year Study. Medicina (Kaunas). 2020 Mar 25;56(4):145. doi: 10.3390/medicina56040145. PMID: 32218369; PMCID: PMC7231131.
Bayers S, Shulman ST, Paller AS. Kawasaki disease: part II. Complications and treatment. J Am Acad Dermatol. 2013 Oct;69(4):513.e1-8; quiz 521-2. doi: 10.1016/j.jaad.2013.06.040. PMID: 24034380.
Tacke CE, Burgner D, Kuipers IM, Kuijpers TW. Management of acute and refractory Kawasaki disease. Expert Rev Anti Infect Ther. 2012 Oct;10(10):1203-15. doi: 10.1586/eri.12.101. PMID: 23199405.
Faim D, Henriques C, Brett A, Francisco A, Rodrigues F, Pires A. Kawasaki Disease: Predictors of Resistance to Intravenous Immunoglobulin and Cardiac Complications. Arq Bras Cardiol. 2021 Mar;116(3):485-491. English, Portuguese. doi: 10.36660/abc.20190758. PMID: 33470332; PMCID: PMC8159558.
Akhtar S, Alam MM, Ahmed MA. Cardiac involvement in Kawasaki disease in Pakistani children. Ann Pediatr Cardiol. 2012 Jul;5(2):129-32. doi: 10.4103/0974- 2069.99612. PMID: 23129899; PMCID: PMC3487198.
Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodó X, Uehara R, Burgner D, Bainto E, Pierce D, Tyree M, Cayan D; Kawasaki Disease Global Climate Consortium. Seasonality of Kawasaki disease: a global perspective. PLoS One. 2013 Sep 18;8(9):e74529. doi: 10.1371/journal.pone.0074529. PMID: 24058585; PMCID: PMC3776809.
Magalhães CM, Vasconcelos PA, Pereira MR, Alves NR, Gandolfi L, Pratesi R. Kawasaki disease: a clinical and epidemiological study of 70 children in Brazil. Trop Doct. 2009 Apr;39(2):99-101. doi: 10.1258/td.2008.080124. PMID: 19299294.
De Melo MFB, De Magalhães CMR, Gomes MC, Moreira NC. Refratariedade ao tratamento da Doença de Kawasaki com imunoglobulina endovenosa: uma análise retrospectiva. Comunicação em Ciências da Saúde. 2020 Jun;30(01). DOI: https://doi.org/10.51723/ccs.v30i01.453.
Alves NR de M, de Magalhães CMR, Almeida R de FR, dos Santos RCR, Gandolfi L, Pratesi R. Estudo prospectivo das complicações da Doença de Kawasaki: análise de 115 casos. Revista da Associação Médica Brasileira. 2011 May; 57(3):299–305. https://doi.org/10.1590/S0104-42302011000300012.
Carlton-Conway D, Ahluwalia R, Henry L, Michie C, Wood L, Tulloh R. Behaviour sequelae following acute Kawasaki disease. BMC Pediatr. 2005 May 25;5(1):14. doi: 10.1186/1471-2431-5-14. PMID: 15916701; PMCID: PMC1156909.
King WJ, Schlieper A, Birdi N, Cappelli M, Korneluk Y, Rowe PC. The effect of Kawasaki disease on cognition and behavior. Arch Pediatr Adolesc Med. 2000 May;154(5):463-8. doi: 10.1001/archpedi.154.5.463. PMID: 10807296.
Knott PD, Orloff LA, Harris JP, Novak RE, Burns JC; Kawasaki Disease Multicenter Hearing Loss Study Group. Sensorineural hearing loss and Kawasaki disease: a prospective study. Am J Otolaryngol. 2001 Sep-Oct;22(5):343-8. doi: 10.1053/ajot.2001.26495. PMID: 11562886.
Magalhães CM, Magalhães Alves NR, Oliveira KM, Silva IM, Gandolfi L, Pratesi R. Sensorineural hearing loss: an underdiagnosed complication of Kawasaki disease. J Clin Rheumatol. 2010 Oct;16(7):322-5. doi: 10.1097/RHU.0b013e3181f603bc. PMID: 20859226.
Keeling IM, Beran E, Dapunt OE. Kawasaki disease and hepatobiliary involvement: report of two cases. Italian Journal of Pediatrics. 2016 Mar 8; 42(1). doi: https://doi.org/10.1186/s13052-016-0238-7.
Taddio A, Pellegrin MC, Centenari C, Filippeschi IP, Ventura A, Maggiore G. Acute febrile cholestatic jaundice in children: keep in mind Kawasaki disease. J Pediatr Gastroenterol Nutr. 2012 Oct;55(4):380-3. doi: 10.1097/MPG.0b013e31825513de. PMID: 22437475.
Bonté I, Mahr A, Laroche L, Guillevin L, Robineau M. Peripheral gangrene in adult- onset Kawasaki disease. Scand J Rheumatol. 2005;34(1):71-3. doi: 10.1080/03009740410011235. PMID: 15903031.
Dogan OF, Kara A, Devrim I, Tezer H, Besbas N, Ozen S, Secmeer G, Yorgancioglu C, Boke E. Peripheral gangrene associated with Kawasaki disease and successful management using prostacycline analogue: a case report. Heart Surg Forum. 2007;10(1):E70-2. doi: 10.1532/HSF98.20061151. PMID: 17311768.
Tahghighi F, Bakhtiari Koohsorkhi M, Ziaee V. Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review. Case Rep Rheumatol. 2021 Apr 13;2021:6629405. doi: 10.1155/2021/6629405. PMID: 33954004; PMCID: PMC8057904.
Takahashi K, Oharaseki T, Naoe S. Pathological study of postcoronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and atherosclerosis. Pediatr Cardiol. 2001 Mar-Apr;22(2):138-42. doi: 10.1007/s002460010180. PMID: 11178671.
Ohno S, Miyajima T, Higuchi M, Yoshida A, Matsuda H, Saheki Y, Nagamatsu I, Togashi T, Matsumoto S. Ocular manifestations of Kawasaki's disease (mucocutaneous lymph node syndrome). Am J Ophthalmol. 1982 Jun;93(6):713-7. doi: 10.1016/0002- 9394(82)90465-2. PMID: 7201245.
Berry S. Ophthalmologic Manifestations of Kawasaki Disease: Overview, Ophthalmologic Presentation, Diagnostic Considerations. Medscape. 2016.
Gao Y, Zhang Y, Lu F, Wang X, Zhang M. Rare ocular manifestations in an 11-year- old girl with incomplete Kawasaki disease: A case report. Medicine (Baltimore). 2018 Jun;97(22):e10974. doi: 10.1097/MD.0000000000010974. PMID: 29851850; PMCID: PMC639270.
