[Kawasaki disease. Analysis of 17 cases]
Gonzalo Quezada-Chavarría1, Raymundo Ramírez-Serrallonga, Scarlett Elizabeth Quezada-Cuevas
1Hospital General Regional 46, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. gonzaquezada_@hotmail.com
Insights
Kawasaki disease (KD) can lead to serious cardiac issues like coronary aneurysms in children. Early diagnosis and treatment with IVIG and aspirin before day 10 are crucial to prevent these severe complications.
Area of Science:
- Pediatric Cardiology
- Immunology
- Rheumatology
Context:
- Kawasaki disease (KD) is a critical pediatric illness primarily affecting coronary arteries.
- Delayed diagnosis and treatment of KD can result in severe cardiac complications, including aneurysms, ischemic heart disease, and sudden death.
- Prompt identification and intervention are essential to mitigate long-term cardiovascular sequelae.
Purpose:
- To review and describe the clinical characteristics, complications, and treatment outcomes of 17 pediatric patients diagnosed with Kawasaki disease.
- To highlight the importance of timely diagnosis and management in preventing cardiac sequelae associated with KD.
Summary:
- A retrospective review of 17 pediatric patients with Kawasaki disease (KD) was conducted.
- Key findings included a male predominance (2.4:1) and an average age of 37 months (range: 15 months to 11 years).
- Four patients developed coronary aneurysms, with treatment involving intravenous immunoglobulin and aspirin initiated before the tenth day of fever.
Impact:
- This case series underscores the predominantly clinical nature of Kawasaki disease diagnosis.
- Emphasizes the critical window for initiating treatment (before day 10 of fever) to prevent irreversible cardiac damage.
- Highlights the effectiveness of intravenous immunoglobulin and aspirin in managing KD and resolving associated complications like coronary artery issues.
Background:
Kawasaki disease (EK) is frequently identified in pediatric patients. It affects principally the coronary arteries, causing aneurysms, ischemic heart disease and sudden death. The opportune diagnosis and its early treatment avoid these complications. Our objective was to describe 17 cases with EK.
Clinical Cases:
seventeen patients' files with EK were reviewed, obtaining information about age, sex, date of admission, clinical manifestations, laboratory results, complications and treatment.
Results:
four patients presented coronary aneurysm. The average age was 37 months, with a range from 15 months to 11 years. There was a predominance of males, with relation 2.4 to 1.
Conclusions:
the EK was not considerated initially; on post-mortem studies, affected coronary arteries were demonstrated. The EK treatment is intravenous gamma-globulin and aspirin and it must be established before the tenth day after the fever begins in order to avoid cardiac complications. Four cases developed AC remitted after 16 months. The EK diagnosis is predominantly clinical.
