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Published on: September 15, 2010
Pattern of clinical features of Kawasaki disease
Mohammed A Muzaffer1, Sulaiman M Al-Mayouf
1Department of Pediatrics, (MBC-58), King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Kingdom of Saudi Arabia. mmuzaffer@kfshrc.edu.sa
Insights
Kawasaki disease in Saudi children presents with common symptoms but a high rate of coronary aneurysm, often linked to delayed diagnosis and treatment. Early intervention is crucial for better outcomes in pediatric cardiology.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease is an acute febrile illness primarily affecting young children.
- It is a leading cause of acquired heart disease in children in developed countries.
- Understanding its presentation in specific populations is crucial for timely management.
Purpose of the Study:
- To investigate the clinical characteristics, complications, and outcomes of Kawasaki disease in Saudi children.
- To identify patterns specific to this demographic and geographic region.
Main Methods:
- Retrospective review of medical records of children diagnosed with Kawasaki disease between 1997 and 2001.
- Data collected included clinical features, laboratory results, echocardiograms, treatment, and outcomes.
- Study conducted at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Main Results:
- Thirteen children (mean age 3.4 years) were analyzed, with 30% experiencing cardiac complications, including coronary artery aneurysms.
- Common symptoms included prolonged fever, rash, conjunctivitis, and oral changes.
- Unusual complications such as hemophagocytic syndrome and peripheral ischemia were also noted.
Conclusions:
- A significant percentage of Saudi children with Kawasaki disease developed coronary aneurysms.
- Delayed diagnosis and treatment initiation are likely contributors to these adverse outcomes.
- This highlights the need for increased awareness and prompt management of Kawasaki disease in the region.
Objective:
To study the pattern of clinical features, complications, and outcome of Kawasaki disease among Saudi children.
Methods:
Medical records and referral letters of all children (1997 through to 2001) diagnosed with Kawasaki disease were reviewed. This study was carried out at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. Collected data included clinical features, laboratory results, echocardiogram findings, therapy, complications and outcome.
Results:
Thirteen children (10 boys, 3 girls) were reviewed, age range from 0.3 to 7 years (mean 3.4 years). Nine patients met 5 out of 6 criteria for the diagnoses of Kawasaki disease and 4 met 4 out of 6 criteria and coronary aneurysm. Thirteen patients had fever and skin rash for more than 5 days, 12 had extremity and oral mucus changes, 9 had bilateral conjunctivitis, and 7 had cervical lymph node enlargement. Other associated clinical features include diarrhea, and aseptic meningitis in 3 patients, ischemia of the fingers and toes in 2, arthritis in 2, arthralgia in one, seizure and pneumonia in one. Hepatosplenomegaly, pancytopenia and elevated liver enzymes in one, hepatomegaly and normal liver enzymes in 2 patients. Cardiac complication seen in 4 patients (30%), all of them were boys, 3 had coronary artery aneurysm (4-7 mm) and one had giant aneurysm (9mm), one of the 3 patients had axillary and subclavian artery aneurysm as well. Two out 4 patients were treated with intravenous immunoglobulin and aspirin within 10 days of illness and one was treated on day 21 and one was treated with aspirin alone. Aneurysmal changes persisted in 3 patients and resolved in one patient who was treated early. Extra-cardiac complications include reaction to intravenous immunoglobulin, coagulopathy, thrombocytopenia, hemophagocytic syndrome and ischemia of peripheral extremities.
Conclusion:
Our observation showed a high percentage (30%) of coronary aneurysm and unusual complications, this is most likely due to delay in the diagnosis and initiation of treatment.
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