Clinical aspects of 100 patients with Kawasaki disease

• Published in: Archives of disease in childhood Vol. 66; no. 2; pp. 185 - 188
• Main Authors: Tizard, E J, Suzuki, A, Levin, M, Dillon, M J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.02.1991; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Arteriosclerosis; Aspirin; Aspirin - therapeutic use; Biological and medical sciences; Blood Sedimentation; Cardiology. Vascular system; Child; Child, Preschool; Children; Clinical aspects; Complications; Coronary Aneurysm - blood; Coronary Aneurysm - etiology; Coronary artery; Coronary Disease - blood; Coronary Disease - etiology; Demographic aspects; Dipyridamole; Dipyridamole - therapeutic use; Diseases; Effusion; Erythrocyte sedimentation rate; Female; Heart rate; Heparin; Humans; Immunoglobulin G - therapeutic use; Immunoglobulins, Intravenous; Infant; Ischemia; Kawasaki disease; Kawasaki syndrome; Leukocyte Count; Male; Medical sciences; Mucocutaneous lymph node syndrome; Mucocutaneous Lymph Node Syndrome - blood; Mucocutaneous Lymph Node Syndrome - drug therapy; Mucocutaneous Lymph Node Syndrome - immunology; Mucocutaneous Lymph Node Syndrome - pathology; Patients; Pediatric diseases; Pediatrics; Platelet Count; Prostacyclin; Retrospective Studies; Streptokinase; Thrombocytosis; Human; Cardiovascular disease; Diagnosis; Mucocutaneous lymph node syndrome; Child
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.66.2.185

We report 101 episodes of Kawasaki disease in 100 patients seen over a 12 year period. A total of 35 patients had cardiac involvement ranging from pericardial effusion to coronary artery aneurysms with ischaemic complications, which resulted in death in one patient. Laboratory investigations showed leucocytosis, thrombocytosis, and a raised erythrocyte sedimentation rate to be common features and the first two variables were significantly associated with cardiac involvement. Treatment regimens changed over the study period. Aspirin was used in most patients often in conjunction with dipyridamole and from 1986 intravenous immunoglobulin was given routinely to those patients seen early in the illness. Additional therapeutic measures in individual patients included prostacyclin, heparin, streptokinase, and plasma exchange/exchange transfusion. Attention is drawn to the uncertainity of the long term cardiovascular consequences in the light of adults reported with premature atherosclerotic lesions of similar appearance to those seen in Kawasaki disease.