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Open Access Research article

Behaviour sequelae following acute Kawasaki disease

Daniel Carlton-Conway2, Raju Ahluwalia2, Lucy Henry4, Colin Michie3, Louise Wood2 and Robert Tulloh1*

Author Affiliations

1 Department of Paediatric Cardiology, Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK

2 Department of Paediatric Cardiology, Guy's and St Thomas' Hospital Trust, Guy's Hospital, St Thomas' Street, London, SE1 9RT, UK

3 Department of Paediatrics, Ealing Hospital, Uxbridge Road, Southall, Middlesex, UB1 3EW, UK

4 Institute of Psychiatry, de Crespigny Park, London, SE5 8AF, UK

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BMC Pediatrics 2005, 5:14  doi:10.1186/1471-2431-5-14

Published: 25 May 2005

Abstract

Background

Kawasaki disease is a systemic vasculitis and may affect cerebral function acutely. The aim of the present study was to measure a number of behaviour and social parameters within a cohort of Kawasaki disease patients.

Methods

Parents of children with past diagnosis of Kawasaki disease were recruited to complete several behaviour screening questionnaires. Sixty five sets of questionnaires relating to the patient cohort received were eligible for inclusion. Two control groups were used, a hospital (HC) control and a sibling control (SC) group.

Results

40% of the Kawasaki disease group showed elevated internalising scores in the clinical or borderline-clinical range. This compared with 18% of hospital controls and 13% of sibling controls. Additionally, the Kawasaki disease (KD) group were shown to be experiencing greater overall total difficulties when compared with the controls (KD 13.7, HC 8.6, SC 8.9). The KD group attained higher behavioural scores within the internalising sub-categories of somatic problems (KD 61, HC 57, SC 54) and withdrawn traits (KD 56, HC 53, SC 51). The KD group were also shown to be suffering more thought problems (KD 57, HC 53, SC 50) compared with the controls. Further difficulties relating to conduct (KD 3.3, HC 1.4) and social interactions (KD 6.7, HC 8.3) are also highlighted for the KD group compared with hospital controls. Positron emission tomograms were performed on nine patients to investigate severe behavioural problems. Three showed minor changes, possibly a resolving cerebral vasculopathy.

Conclusion

Kawasaki disease can be associated with significant behavioural sequelae. This is an important consideration in the long-term follow up and referral to a clinical psychologist may be necessary in selected patients.

Keywords:
Kawasaki Disease; Cerebral Vasculitis; Psychological Difficulties; Long Term Management