[Review and analysis of 283 cases of Kawasaki disease].
OBJECTIVE
The aim of the study was to review the cases of Kawasaki Disease (KD) and analyze the clinical features especially their cardiac complications.


METHODS
Totally 283 patients with KD were hospitalized from 1992 to 2002. Their clinical features and factors associated with increased risk of coronary artery aneurysms were reviewed.


RESULTS
(1) Among the 283 KD patients, 186 were male and 97 were female. The male-female ratio was 1.9:1. Most of them (71%) were younger than 3 years old. Seasonal peak was in spring and summer (from May to Aug). Depending on the criteria of KD, 228 (81%) were diagnosed as typical KD and 55 (19.4%) were atypical KD. All patients had fever, lasting for 6.1 days. The most common clinical features were oral mucosal changes (97.5%) and cervical lymphadenopathy (95.4%), conjunctivitis (91.2%). And changes in the extremities (89.8%) and rash (81.5%) were also noted. (2) Before the treatment, coronary artery abnormalities were seen in 103/279 (36.9%), which occurred within 4 - 30 days of fever onset. Two weeks after intravenous gamma globulin (IVIG) treatment, the new cases of coronary artery abnormalities were 28/211 (13.3%). The prevalence of coronary artery aneurysms (CAA) with KD was 4.7%. The risk factors of CAA were male cases (P < 0.05) and fever lasting longer than 9 days (P < 0.05). Other cardiac abnormalities in acute phase included left atrial and ventricular enlargement (40/279, 14.3%) and changes in ECG (57/274, 20.8%). The pericardial effusions were found in 11 cases (3.9%).


CONCLUSIONS
Cardiac complications of KD occurred in the early period of KD. The new cases of coronary artery abnormalities were 13.3% after IVIG treatment. The risk factors of CAA included male cases and fever lasting for longer time.
Wang
Li
L
Department of Internal Medicine, Capital Institute for Pediatrics, Beijing 100020, China.
Lin
Yi
Y
Su
Ying-Zi
YZ
Wang
Yun
Y
Zhao
Di
D
Wu
Tie-Ji
TJ
D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015995:Prevalence; D012307:Risk Factors
D016756:Immunoglobulins, Intravenous