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Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment

INTRODUCTION: Kawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the...

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Autores principales: Cheah, Chooi San, Lee, Wendy Wei Li, Suhaini, Siti Aisyah, Azidin, Abdullah Harith, Khoo, Mohammad Shukri, Ismail, Noor Akmal Shareela, Ali, Adli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9880227/
https://www.ncbi.nlm.nih.gov/pubmed/36714643
http://dx.doi.org/10.3389/fped.2022.1090928
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author Cheah, Chooi San
Lee, Wendy Wei Li
Suhaini, Siti Aisyah
Azidin, Abdullah Harith
Khoo, Mohammad Shukri
Ismail, Noor Akmal Shareela
Ali, Adli
author_facet Cheah, Chooi San
Lee, Wendy Wei Li
Suhaini, Siti Aisyah
Azidin, Abdullah Harith
Khoo, Mohammad Shukri
Ismail, Noor Akmal Shareela
Ali, Adli
author_sort Cheah, Chooi San
collection PubMed
description INTRODUCTION: Kawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the epidemiology, clinical features, treatment, and outcomes of KD among the pediatric patients admitted to Hospital Canselor Tunku Muhriz (HCTM), Kuala Lumpur, Malaysia. METHOD: A retrospective cohort study of 66,500 pediatric patients presented at HCTM from the year 2004 to 2021 was conducted. RESULTS: 62 KD cases out of 66,500 pediatric admissions were reported, with a male-to-female ratio of 1.58 to 1. Majority of KD patients (95.0%) were younger than 5 years old. Prior infection was reported in 5 KD patients (8.1%). Apart from the classical features, manifestations of various organ systems including cardiovascular (16.1%), gastrointestinal (43.5%), neurological (1.61%), musculoskeletal (1.61%), and genitourinary (17.7%) systems were observed. There was a significant association between sterile pyuria and coronary artery aneurysm (CAA) (p < 0.05). Interestingly, abnormal liver parameters (p < 0.05) and incomplete KD (p < 0.05) were significantly related to IVIG resistance. DISCUSSION: The presence of family history, immunological disorder, and previous infection in our KD patients suggested that there is a possibility of genetic, immunological, and infectious roles in the pathophysiology of KD. IVIG resistance is more likely to occur in KD patients with hepatic dysfunction or incomplete KD presentation. These findings highlighted the significant contribution of laboratory parameters to the prognosis of KD, prompting more in-depth research on the KD scoring systems and their relevance in this country.
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spelling pubmed-98802272023-01-28 Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment Cheah, Chooi San Lee, Wendy Wei Li Suhaini, Siti Aisyah Azidin, Abdullah Harith Khoo, Mohammad Shukri Ismail, Noor Akmal Shareela Ali, Adli Front Pediatr Pediatrics INTRODUCTION: Kawasaki disease (KD) is an acute idiopathic systemic vasculitis with a self- limiting course that predominantly affects children under 5 years old, particularly in the East Asian countries. Nevertheless, to date, the data on KD in Malaysia are limited. This study aimed to evaluate the epidemiology, clinical features, treatment, and outcomes of KD among the pediatric patients admitted to Hospital Canselor Tunku Muhriz (HCTM), Kuala Lumpur, Malaysia. METHOD: A retrospective cohort study of 66,500 pediatric patients presented at HCTM from the year 2004 to 2021 was conducted. RESULTS: 62 KD cases out of 66,500 pediatric admissions were reported, with a male-to-female ratio of 1.58 to 1. Majority of KD patients (95.0%) were younger than 5 years old. Prior infection was reported in 5 KD patients (8.1%). Apart from the classical features, manifestations of various organ systems including cardiovascular (16.1%), gastrointestinal (43.5%), neurological (1.61%), musculoskeletal (1.61%), and genitourinary (17.7%) systems were observed. There was a significant association between sterile pyuria and coronary artery aneurysm (CAA) (p < 0.05). Interestingly, abnormal liver parameters (p < 0.05) and incomplete KD (p < 0.05) were significantly related to IVIG resistance. DISCUSSION: The presence of family history, immunological disorder, and previous infection in our KD patients suggested that there is a possibility of genetic, immunological, and infectious roles in the pathophysiology of KD. IVIG resistance is more likely to occur in KD patients with hepatic dysfunction or incomplete KD presentation. These findings highlighted the significant contribution of laboratory parameters to the prognosis of KD, prompting more in-depth research on the KD scoring systems and their relevance in this country. Frontiers Media S.A. 2023-01-13 /pmc/articles/PMC9880227/ /pubmed/36714643 http://dx.doi.org/10.3389/fped.2022.1090928 Text en © 2023 Cheah, Lee, Suhaini, Azidin, Khoo, Ismail and Ali. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Cheah, Chooi San
Lee, Wendy Wei Li
Suhaini, Siti Aisyah
Azidin, Abdullah Harith
Khoo, Mohammad Shukri
Ismail, Noor Akmal Shareela
Ali, Adli
Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title_full Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title_fullStr Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title_full_unstemmed Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title_short Kawasaki disease in Malaysia: Biochemical profile, characterization, diagnosis and treatment
title_sort kawasaki disease in malaysia: biochemical profile, characterization, diagnosis and treatment
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9880227/
https://www.ncbi.nlm.nih.gov/pubmed/36714643
http://dx.doi.org/10.3389/fped.2022.1090928
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