Clinical and Laboratory Characteristics of Kawasaki Disease in Iran: a Systematic Review and Meta-analysis Study

Document Type: systematic review

Authors

1 Epidemiologist and Research Assistant, Amir Kabir Hospital, Amiralmomenin Hospital, Ayatollah Khansari Hospital, Arak University of Medical Sciences, Arak, Iran.

2 Pediatric Cardiologist, Amir Kabir Hospital, Arak University of Medical Sciences, Arak, Iran.

Abstract

Background: Kawasaki Disease (KD) is a common systemic vasculitis, which mostly develops in children under five years. To date, based on our search, various, but no meta-analysis, studies were conducted to evaluate the clinical and laboratory findings of Kawasaki Disease (KD) in Iran. We aimed to evaluate these characteristics in Iranian children with KD.
Methods: In this Systematic review and meta-analysis, International and National Electronic databases, including Medline, Scopus, ISI Web of Science, EMBASE, Medlib, SID, Iranmedex, Magiran, and Irandoc and the reference lists of the selected studies were searched until February 2020. The keywords of KD and characteristics was combined and searched. Search, review, selecting, and extraction of papers was performed by two authors independently.  The prevalence rates of all clinical and laboratory characteristics of KD and involvement of other organs were extracted and analyzed by the random effect model using the STATA software (version.11) at 95% of confidence interval (CI).
Results: Finally, 1141 participants from 20 studies were entered to this meta-analysis. In clinical findings among KD patients fever was 100%, change in oral cavity and lips was 82%, bilateral conjunctiva was 78%, rash was 74%, change in extremities was 62%, agitation was 53%, and cervical lymphadenopathy was 50%. In laboratory findings, ESR was 86%, CRP was 67%, leukocytosis was 62%, Hb<10 g/dl was 59%, thrombocytosis was 55%, SGOT elevated was 34%, sterile pyuria was 33%, albuminuria was 31%, and SGPT elevated was 30%. In involvement of other organ, desquamation was 57%, vomiting was 30%, arthritis was 28%, diarrhea was 24%, coronary complication was 17%, coronary aneurysm was 17%, arthralgia was 16%, cardiac involvement was 10%, aseptic meningitis was 6%, gallbladder hydrops was 5%, and BCG inoculation site was 3%.
Conclusion: Based on our finding, fever, ESR, and desquamation are most prevalent clinical, laboratory, and involvement of other organ characteristics respectively. Therefore, the results of this meta-analysis is a good evidence for assessing the findings of KD patients in Iran and can be effective in diagnosis of KD.

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