Article Dans Une Revue Autoimmunity Reviews Année : 2015

Kawasaki disease in adults: observations in France and literature review Short title: Kawasaki disease in adults in France

1 Hôpital Saint-Louis
2 UNICANCER/CRCL - Centre de Recherche en Cancérologie de Lyon
3 Service Médecine Interne - site Gabriel-Montpied [CHU Clermont-Ferrand]
4 Service de Médecine interne
5 CH Montélimar - Centre hospitalier de Montélimar [Hôpital de Montélimar] = Montélimar Hospital
6 Service Médecine Interne et immunologie clinique [CHU Toulouse]
7 Service Médecine interne et immunopathologie clinique [CHU Toulouse]
8 Service de Médecine Interne
9 CHR Metz-Thionville - Centre hospitalier régional de Metz-Thionville
10 Centre Hospitalier de Charleville-Mezières
11 RIGHT - Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098)
12 CIC - CHU Henri Mondor
13 CHU Reims - Hôpital universitaire Robert Debré [Reims]
14 CHU Saint-Antoine [AP-HP]
15 Service de Médecine interne [CHU Saint-Etienne]
16 Service de médecine interne et maladies infectieuses [Bordeaux]
17 Department of infectious diseases
18 Service des Maladies Infectieuses
19 CHU Pitié-Salpêtrière [AP-HP]
20 Service de médecine interne [CHU Caen]
21 CHU Tenon [AP-HP]
22 Service de Néphrologie - Médecine Interne
23 Centre Hospitalier Creil
24 Hôpital Nord [CHU - APHM]
25 Service de pneumologie [Rennes] = Pneumology [Rennes]
26 Centre de référence des maladies autoimmunes et systémiques rares
27 IC UM3 (UMR 8104 / U1016) - Institut Cochin
28 Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
29 Service de Pédiatrie Générale et Rhumatologie Pédiatrique
30 Service Pédiatrie
Eric Oziol
  • Fonction : Auteur
  • PersonId : 953623
Amar Smail
  • Fonction : Auteur
  • PersonId : 1522725
  • IdRef : 070287473
Brigitte Granel
Arsène Mekinian
Isabelle Kone-Paut
  • Fonction : Auteur
  • PersonId : 947672
Olivier Fain

Résumé

Objective Kawasaki disease (KD) is a vasculitis that mostly occurs in young children and rarely in adults. We analyzed the characteristics of adult-onset KD (AKD) in France. Methods We collected retrospective and prospective data for patients with a diagnosis of KD occurring after the age of 18 years. Cases were obtained via various French medical networks and identified from the international literature. Results We included 43 patients of AKD at 26 institution from 1992 to 2015, with mean (SD) age 30 (11) years (range 18–68) and sex ratio (M/F) 1.2; 34 patients met the American Heart Association criteria and 9 were incomplete AKD. The median time to diagnosis was 13 days (interquartile range 8–21). The main symptoms were fever (100%), exanthema (98%), changes in the extremities (91%), conjunctivitis (77%), oral cavity changes (89%), cervical adenitis (55%) and cardiac abnormalities (45%). Overall, 35% of patients showed large-vessel vasculitis: coronary vasculitis (26%) and coronary aneurysm (19%). Treatment was mostly intravenous immunoglobulins (79%) and aspirin (81%). Four patients showed myocardial infarction due to coronary vasculitis, but none were treated with IVIg because of late diagnosis. After a median follow-up of 5 months (range 1–117), persistent aneurysm was noted in 9% of cases. Damage was significantly lower with early treatment than late or no treatment (p = 0.01). Conclusion Given the high frequency of cardiac involvement and complications in this series of AKD, diagnosis and treatment should not be delayed, and early IVIg treatment seems to improve the outcome

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hal-01240471 , version 1 (17-12-2015)

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Jean-Baptiste Fraison, Pascal Seve, Claire Dauphin, Alfred Mahr, Emeline Gomard-Mennesson, et al.. Kawasaki disease in adults: observations in France and literature review Short title: Kawasaki disease in adults in France. Autoimmunity Reviews, 2015, In press. ⟨10.1016/j.autrev.2015.11.010⟩. ⟨hal-01240471⟩
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