Background
Kawasaki Disease (KD) and rhino sinusitis are common in young Iranian population. Paranasal sinusitis can cause immunologic reactions and progress to KD. We compared the incidence of rhino sinusitis based on para nasal sinus- computed tomography scans (PNS-CT Scan), in KD cases with control group (head trauma)
Methods
A prospective, case control study (2013-18)had done in Rasul Akram Hospital in Tehran, Iran.PNS- CT scan finding compared between 43 proven KD and 43 controls (head trauma). The PNS-CTscan changes compared between 2 groups respect to their ages, gender, site and type of sinusitis.
Results
PNS-CT scan had been performed in 23 cases with proved KD and 43 non KD cases( control) with mean age of 6.48 ± 4.15 years in KD cases without significant difference to controls (p = 0.14.). No significant difference had seen in gender between two groups. (p = 0.14).The paranasal sinusitis had higher prevalence in KD cases in compare with controls: 41.86% (18 / 43) vs 20.9% (9 / 43) respectively (P = 0.036). The mean age of children with sinusitis had not difference between groups (7.44 ± 0.89 vs. 7.88 + 2.44, p = 0.176). Presence of sinusitis in cases and controls were not related to age, sex and site of sinusitis (p = 0.71; 0.80; 0.63 respectively).
Conclusion
The result of this investigation shows the high prevalence of paranasal sinusitis in KD which suggest the sinusitis as an important factor for developing the KD. Although, the presence of sinus pathology on a PNS- CT scan does not establish the causality between sinusitis and KD, but due to high prevalence of paranasal sinusitis in our pediatric population, we recommend PNS CT-scan for KD cases with prolonged URI ( Upper Respiratory Tract Infection) symptoms more than 2 weeks. In KD cases with confirmed paranasal sinusitis, antibiotic treatment is recommend to prevent relapses and complications of the KD treatment.