Pediatrics

Review and analysis of 283 cases of Kawasaki disease

Zhonghua Er Ke Za Zhi. 2004 Aug;42(8):609-12.


[Article in Chinese]

Wang L, Lin Y, Su YZ, Wang Y, Zhao D, Wu TJ.

Department of Internal Medicine, Capital Institute for Pediatrics, Beijing 100020, China.

OBJECTIVE: The aim of the study was to review the cases of Kawasaki Disease (KD) and analyze the clinical features especially their cardiac complications. METHODS: Totally 283 patients with KD were hospitalized from 1992 to 2002. Their clinical features and factors associated with increased risk of coronary artery aneurysms were reviewed. RESULTS: (1) Among the 283 KD patients, 186 were male and 97 were female. The male-female ratio was 1.9:1. Most of them (71%) were younger than 3 years old. Seasonal peak was in spring and summer (from May to Aug). Depending on the criteria of KD, 228 (81%) were diagnosed as typical KD and 55 (19.4%) were atypical KD. All patients had fever, lasting for 6.1 days. The most common clinical features were oral mucosal changes (97.5%) and cervical lymphadenopathy (95.4%), conjunctivitis (91.2%). And changes in the extremities (89.8%) and rash (81.5%) were also noted. (2) Before the treatment, coronary artery abnormalities were seen in 103/279 (36.9%), which occurred within 4 - 30 days of fever onset. Two weeks after intravenous gamma globulin (IVIG) treatment, the new cases of coronary artery abnormalities were 28/211 (13.3%). The prevalence of coronary artery aneurysms (CAA) with KD was 4.7%. The risk factors of CAA were male cases (P < 0.05) and fever lasting longer than 9 days (P < 0.05). Other cardiac abnormalities in acute phase included left atrial and ventricular enlargement (40/279, 14.3%) and changes in ECG (57/274, 20.8%). The pericardial effusions were found in 11 cases (3.9%). CONCLUSIONS: Cardiac complications of KD occurred in the early period of KD. The new cases of coronary artery abnormalities were 13.3% after IVIG treatment. The risk factors of CAA included male cases and fever lasting for longer time.

PMID: 15347450 [PubMed - in process]
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