TY - JOUR
T1 - Kawasaki Disease Shock Syndrome vs Classical Kawasaki Disease
T2 - A Meta-analysis and Comparison With SARS-CoV-2 Multisystem Inflammatory Syndrome
AU - Lamrani, Loubna
AU - Manlhiot, Cedric
AU - Elias, Matthew D.
AU - Choueiter, Nadine F.
AU - Dionne, Audrey
AU - Harahsheh, Ashraf S.
AU - Portman, Michael A.
AU - McCrindle, Brian W.
AU - Dahdah, Nagib
N1 - Publisher Copyright:
© 2021 Canadian Cardiovascular Society
PY - 2021/10
Y1 - 2021/10
N2 - Background: The emergence of increasing reports worldwide of a severe inflammatory process and shock in pediatric patients resembling Kawasaki disease (KD)—and, more specifically, Kawasaki disease shock syndrome (KDSS)—prompted us to explore KDSS in a preamble of a systematic comparison between the 2 conditions. Methods: We completed a systematic review of KDSS and performed a meta-analysis comparison between reported KDSS cases and KD controls. Results: A total of 10 case-control series were included in the meta-analysis. Patients with KDSS were older (38.4 ± 30.6 vs 21.9 ± 19.5 months; P < 0.001) compared with standard KD with equal sex distribution and completeness of clinical diagnostic criteria. KDSS present higher C-reactive protein (59.4 ± 29.2 mg/dL vs 20.8 ± 14.8 mg/dL; P < 0.001), lower albumin (2.7 ± 0.5 g/dL vs 3.3 ± 0.5 g/dL; P < 0.01), and lower platelets (255 ± 149 109/L vs 394 ± 132 109/L; P < 0.001) but only borderline higher white blood cells (P = 0.06). Differences in alanine transaminase, aspartate aminotransferase, and erythrocyte sedimentation rate were nonsignificant. The odds of intravenous immunoglobulin resistance (44.4% vs 9.6%; (P < 0.001) and the hospital length of stay (10.9 ± 5.8 vs 5.0 ± 3.0 days; P < 0.001) were higher in KDSS, as were the odds of coronary-artery abnormalities (33.9% vs 8.6%; P < 0.001). Conclusions: This first meta-analysis on KDSS vs KD represents a basis for future works on KDSS and opens the opportunity for future multicentre studies in the search of causal relationships between presenting elements and the eventual complications of KDSS. The similarities between SARS-CoV-2 multisystem inflammatory syndrome in children and KDSS open new horizons to the understanding of the etiology and pathophysiology related to KDSS.
AB - Background: The emergence of increasing reports worldwide of a severe inflammatory process and shock in pediatric patients resembling Kawasaki disease (KD)—and, more specifically, Kawasaki disease shock syndrome (KDSS)—prompted us to explore KDSS in a preamble of a systematic comparison between the 2 conditions. Methods: We completed a systematic review of KDSS and performed a meta-analysis comparison between reported KDSS cases and KD controls. Results: A total of 10 case-control series were included in the meta-analysis. Patients with KDSS were older (38.4 ± 30.6 vs 21.9 ± 19.5 months; P < 0.001) compared with standard KD with equal sex distribution and completeness of clinical diagnostic criteria. KDSS present higher C-reactive protein (59.4 ± 29.2 mg/dL vs 20.8 ± 14.8 mg/dL; P < 0.001), lower albumin (2.7 ± 0.5 g/dL vs 3.3 ± 0.5 g/dL; P < 0.01), and lower platelets (255 ± 149 109/L vs 394 ± 132 109/L; P < 0.001) but only borderline higher white blood cells (P = 0.06). Differences in alanine transaminase, aspartate aminotransferase, and erythrocyte sedimentation rate were nonsignificant. The odds of intravenous immunoglobulin resistance (44.4% vs 9.6%; (P < 0.001) and the hospital length of stay (10.9 ± 5.8 vs 5.0 ± 3.0 days; P < 0.001) were higher in KDSS, as were the odds of coronary-artery abnormalities (33.9% vs 8.6%; P < 0.001). Conclusions: This first meta-analysis on KDSS vs KD represents a basis for future works on KDSS and opens the opportunity for future multicentre studies in the search of causal relationships between presenting elements and the eventual complications of KDSS. The similarities between SARS-CoV-2 multisystem inflammatory syndrome in children and KDSS open new horizons to the understanding of the etiology and pathophysiology related to KDSS.
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U2 - 10.1016/j.cjca.2021.05.014
DO - 10.1016/j.cjca.2021.05.014
M3 - Review article
C2 - 34090979
AN - SCOPUS:85112337191
SN - 0828-282X
VL - 37
SP - 1619
EP - 1628
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 10
ER -