H - 65 Clinical Evidence for an Age-Dependent Relationship between Kawasaki Disease and Cognition in a Latinx/e Girl.

Abstract

Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed countries (e.g., Japan, U.S.). Rare in the U.S., the systemic, acute inflammation condition with typical symptoms of a fever, cervical lymphadenopathy, conjunctivitis, extremity changes, and exanthema, can cause long term post-inflammatory neurological and emotional changes. Cognitive deficits (e.g., ADHD) can emerge post-KD but the literature is equivocal and to-date there are no U.S. studies. We report the case of an 11-year-old Latinx/e girl to expand knowledge of KD-related cognitive changes. Comprehensive neuropsychological assessment of an 11-year-old with KD diagnosed in early childhood and hemiplegic migraines, academic difficulties and emotional intolerance. Overall ability was within the low average range with significant negative impact of slow processing speed. Academic assessment demonstrated moderate impairment in reading, and mild math impairment. Memory, expressive/receptive language, visuospatial, and psychomotor abilities were within expectation. Variable complex attention, impulsivity, inattention, and poor self-monitoring were evident. Mild anxiety was reported. Resulting diagnoses of ADHD, and Reading Disorder were offered. KD may produce inflammation in the brain and neurological changes which may lead to later cognitive impairment. This 11-year-old Latinx/e girl's cognitive profile supports recent literature suggesting KD-related cognitive difficulties likely develop between 5-10yrs after KD diagnosis and reinforces the need for longitudinal research. Furthermore, it expands the literature regarding the neuropsychological effects of KD on cognitive functioning in Latinx/e children in the U.S as to date most research has focused on children of Asian-descent.