Behaviour sequelae following acute Kawasaki disease.
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higher behavioural scores within the internalising sub-categories of somatic problems (KD 61, HC 57, SC 54) and withdrawn traits (KD 56, HC 53, SC 51).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.


CONCLUSIONS
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.
Carlton-Conway
Daniel
D
Department of Paediatric Cardiology, Guy's and St Thomas' Hospital Trust, Guy's Hospital, St Thomas' Street, London, SE1 9RT, UK. Robert.Tulloh@ubht.swest.nhs.uk
Ahluwalia
Raju
R
Henry
Lucy
L
Michie
Colin
C
Wood
Louise
L
Tulloh
Robert
R
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000523:psychology*; D012189:Retrospective Studies; D035781:Siblings; D013315:Stress, Psychological; D011795:Surveys and Questionnaires