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Cardiac complications in children with Kawasaki disease in our own experience
Ewelina Gowin1, Ilona Małecka, Joanna Stryczyńska-Kazubska
1Department of Family Medicine, Poznan University of Medical Sciences, Poland Specialist Mother and Child Healthcare Facility, Poznan, Poland. ewego@poczta.onet.pl.
Insights
Kawasaki disease, a common cause of acquired heart disease in children, frequently leads to cardiac complications. Early cardiac evaluation and long-term monitoring are crucial for affected children.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease is a leading cause of acquired heart disease in children globally.
- Incidence varies significantly by region, with higher rates in Japan and lower rates in Europe and the US.
- Understanding cardiac complications is vital for pediatric health.
Purpose of the Study:
- To evaluate the spectrum and incidence of cardiac complications in children hospitalized with Kawasaki disease.
- To assess the diagnostic criteria and outcomes of Kawasaki disease in a Polish pediatric population.
Main Methods:
- Retrospective analysis of medical records of 30 children diagnosed with Kawasaki disease between 2008-2014.
- Diagnosis adherence to the American Heart Association criteria.
- Inclusion of clinical data, laboratory findings, and cardiac assessment results.
Main Results:
- Cardiac involvement was observed in 60% of patients, with coronary artery abnormalities (dilatation or aneurysms) in 13.3% to 20%.
- Other cardiac complications included pericarditis (6 patients) and valvular regurgitation (mitral and aortic).
- 18% of patients experienced multiple cardiac issues; coronary artery dilatation resolved in most cases within a year.
Conclusions:
- Kawasaki disease necessitates consideration in children with prolonged fever, requiring prompt cardiac evaluation.
- Regular cardiac monitoring during the acute phase and long-term follow-up are essential for managing cardiovascular sequelae.
- Implementation of a national reporting system for Kawasaki disease in Poland is recommended to improve surveillance.
Background:
Kawasaki disease is the most common cause of acquired heart disease in children in developed countries. The incidence of Kawasaki disease varies from 180 in Japan through 20 in United States to 5-8 in the European countries per 100,000 children younger than 5 years of age.
Aim:
To evaluate cardiac complications in children hospitalised with Kawasaki disease.
Methods:
Retrospective analysis of the medical records of patients hospitalised with Kawasaki disease in the Specialist Mother and Child Healthcare Facility in Poznan (Poland) in 2008-2014. The diagnosis was based on the American Heart Association criteria.
Results:
Study group included 30 patients (25 boys and 5 girls). The mean age was 49 months; 21 (70%) children were younger than 5 years of age. All patients had oral mucosal lesions, while an elevated leukocyte count was observed in a minority of patients. Cardiac involvement was detected in 18 (60%) patients, aneurysms in 4 (13.3%) patients, coronary artery dilatation in 6 patients, pericarditis in 6 patients, mitral regurgitation in 3 patients, and aortic regurgitation in 2 patients. In 5 children, more than 1 cardiac abnormality was detected. During 12 months of follow-up, coronary artery dilatation resolved in 5 children, and 1 patient developed aneurysm.
Conclusions:
Our findings suggest that Kawasaki disease should be considered in the differential diagnosis of children with prolonged fever. During the acute stage of the disease, children with Kawasaki disease require regular cardiac evaluation, and long-term care is needed when cardiovascular complications occur. A central case reporting system to monitor all cases of Kawasaki disease in the Polish paediatric population should be introduced.
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