Kawasaki disease: The clinical and cardiologic earlyterm characteristics and prognoses of 44 children with acute attack

Abstract

Objective: In this study, we evaluated the clinical, laboratory and echocardiographic features of the children with Kawasaki disease (KD) who were admitted and treated in our hospital. Material and Methods: We retrospectively evaluated the medical records of 44 children diagnosed with KD in our clinic between May 1, 2008 and December 31, 2014. According to the diagnostic criteria of KD, the patients were classified as complete and incomplete. We evaluated the clinical, laboratory and echocardiographic findings at the time of diagnosis. Results: A total of 44 children (29 boys and 15 girls) with KD were included in this study. The mean age of children was 47.65±22.56 (18-96) months. Thirty eight patients (86.4%) were diagnosed with complete and 6 (13.6%) were diagnosed with incomplete KD. The mean duration of fever before diagnosis was 7.12±2.2 (5-14) days. All of the patients had fever and changes in oral cavity. The incidence of cervical lymphadenopathy, conjunctivitis, changes in the extremities and skin rash were 93.2%, 65.9%, 54.5% and 18.2%, respectively. During the first evaluation, 28 (63.6%) patients had normal echocardiographic findings. Six (13.6%) patients had coronary artery aneurysm, 5 (11.4%) had minimally coronary artery ectasia and 5 (11.4%) had pericardial effusion. All of the patients were treated with intravenous immunoglobulin and acetyl salicylate. Only two unresponsive patients received steroids in addition to this treatment. The clinical and laboratory findings of the patients without coronary artery aneurysm returned to normal in eight weeks. The patients were followed up for a mean of 11.65±11.17 (2-58) months. Complete regression of coronary artery aneurysm was observed in three of six patients, but three had persistent minimal coronary artery ectasia. Conclusion: Our study demonstrated that considerable number of patients with KD have coronary artery lesions and early administration of intravenous immunoglobulin may prevent the development of the complications. The children under five years with prolonged fever should be kept in mind in terms of early diagnosis of KD and coronary artery lesions related mortality and morbidity.