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[Kawasaki disease in Mexican children]
A Vizcaíno-Alarcón1, A Arévalo-Salas, A M Rodríguez-López
1Departamento de Investigaciones Cardiológicas, Hospital Infantil de México Federico Gómez, D.F.
Insights
Kawasaki disease (KD) is present in Mexico, affecting predominantly young males. A scoring system can predict severe coronary anomalies and outcomes in children with KD.
Area of Science:
- Pediatric Cardiology
- Rheumatology
- Infectious Diseases
Context:
- Kawasaki disease (KD) is a critical pediatric illness primarily affecting coronary arteries.
- Understanding KD epidemiology and clinical manifestations in diverse geographic regions is crucial for early diagnosis and management.
- This study reviews KD cases from Mexico Children's Hospital, contributing to the understanding of the disease in this population.
Purpose:
- To review and analyze the clinical characteristics, coronary artery involvement, and outcomes of Kawasaki disease patients at a single institution in Mexico.
- To evaluate the utility of a coronary risk scoring system in predicting severe coronary anomalies and clinical outcomes in KD patients.
- To establish the prevalence and significance of KD in Mexico based on the largest reported single-institution series.
Summary:
- Sixteen pediatric KD cases were analyzed, with a mean age of three years, male predominance (4.3:1), and two sibling cases.
- Myocarditis was observed in six patients, and 12 had coronary anomalies, including five with aneurysms. Two infants with severe coronary disease died.
- A coronary risk score of 6 or more points strongly correlated with coronary anomalies, giant aneurysms, and mortality, while fewer points indicated better outcomes.
Impact:
- This study confirms the presence and significant impact of Kawasaki disease in Mexico.
- The findings highlight the importance of early identification and risk stratification using a scoring system to predict severe coronary sequelae.
- Results underscore the need for heightened awareness and specialized care for KD patients to prevent long-term cardiovascular complications.
Abstract:
The records of 16 cases seen at Mexico Children's Hospital with a diagnosis of KD were reviewed. Mean age was three years; eight were infants, and males were dominant with a ratio of 4.3:1. Two cases occurred in sibling. Evidence of myocarditis was recognized in six, and 12 had coronary anomalies, including five with aneurysms. Two infants with severe coronary disease died, one suddenly with myocardial ischemia, and one with a ruptured aortic aneurysm. Another infant developed severe stenosis of the right coronary artery but remains asymptomatic. Two cases have persistent coronary ectasia and seven are asymptomatic with a normal echocardiogram. Predictors of coronary risk were correlated with clinical outcome. All six cases with 6 or more points had coronary anomalies, two developed giant aneurysms, two died and one has severe coronary stenosis. Of 10 cases with less than 6 points, four did not have coronary involvement, none developed giant aneurysms and none died nor developed severe coronary sequelae. Although KD has been sporadically reported in this country, the present series, the largest from a single institution, firmly establishes the presence of the disease in Mexico.
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