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Kawasaki disease--the Northern Ireland experience
1Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Northern Ireland.
Insights
Kawasaki Disease incidence rose in Northern Ireland, with 40% experiencing cardiac issues like coronary artery dilation. Persistent cardiac changes were seen in over half of affected children one year post-illness.
Area of Science:
- Pediatrics
- Cardiology
- Epidemiology
Background:
- Kawasaki Disease (KD) is a significant cause of acquired heart disease in children.
- Understanding regional incidence and cardiac involvement is crucial for pediatric health management.
Purpose of the Study:
- To analyze the incidence and cardiac complications of Kawasaki Disease in Northern Ireland between 1985-1991.
- To report on the long-term cardiac sequelae of KD in this population.
Main Methods:
- Retrospective review of 45 identified Kawasaki Disease cases from 1985-1991.
- Utilized 2D Echocardiography to assess cardiac involvement (coronary artery dilatation, pericardial effusion).
- Follow-up assessments conducted one year post-disease onset.
Main Results:
- Incidence peaked in 1988 at 19 per million (under 16s), the highest in the UK.
- 40% of patients had coronary artery dilatation/aneurysm; 17.7% had pericardial effusion.
- 53% showed persistent coronary artery changes one year later; one patient required bypass surgery.
Conclusions:
- Northern Ireland experienced a high incidence of Kawasaki Disease with significant cardiac involvement.
- Long-term cardiac sequelae are common, necessitating vigilant follow-up.
- A management and follow-up protocol for KD is proposed.
Abstract:
In the period 1985-1991 inclusive, forty five cases of Kawasaki Disease were identified in Northern Ireland. The number of cases increased each year until 1988 when the incidence was 19 per million population under 16 years, the highest reported for any region in the United Kingdom (data from British Paediatric Surveillance Unit). A high incidence of cardiac involvement was found, with 18(40%) having proximal coronary artery dilatation or aneurysm. and 8(17.7%) with pericardial effusion detected by 2D Echocardiography during or shortly after the acute illness. One year after disease onset, persistent coronary artery changes were detectable by 2D Echocardiography in 53% of those initially affected. There have been no deaths and no patient has so far developed myocardial infarction. One patient has required coronary artery bypass grafting. A protocol for the acute management and long term follow-up of Kawasaki Disease is suggested.