Clinical and laboratory features and disease outcome of kawasaki disease: the analysis of our experience and literature review.
Clinical, laboratory features and the outcome of 73 children affected with Kawasaki Disease (KD) (62 with typical KD and 11 in which one or more of the Japanese Committee criteria were lacking) were analyzed and compared with those of the literature. All patients, except 14 admitted before 1982, received the current specific treatment with aspirin and intravenous immunoglobulin (WIG) (400 mg/kg/for 5 days or a single infusion of 2 g/kg). Three children underwent a second cycle of IVIG because fever and coronary alterations persisted after the first infusion. The frequency of cardiac involvement in our complete KD (29|X%) was comparable with that reported in the literature (coronary dilatation 20|X% and coronary aneurysm 4|X%), while in the incomplete cases no coronary abnormalities were detected. The outcome of the KD was good in all children. Remodeling of coronary vessels was noted in all patients with coronary artery damage, 2 to 24 months from the disease onset.We believe that the frequency of atypical or incomplete KD needs emphasis. Since others have reported coronary abnormalities in such cases, close 2D echocardiographic monitoring should be done in all children with otherwise unexplained prolonged fever, red lips, leukocytosis, and high erythrocyte sedimentation rate. We believe that when KD is strongly suspected, even in absence of all criteria for the diagnosis, prompt treatment with both aspirin and IVIG is appropriate to avoid even a low risk of coronary damage.
Generini
S
S
Department of Pediatrics, Rheumatology Unit, and the Institute of Internal Medicine IV, University of Florence, Italy. Department of Pediatrics, University of Florence. Via Luca Giordano, 13-50132, Florence, Italy.
Ermini
M
M
Taccetti
G
G
Trapani
S
S
Cerinic
M M
MM
Falcini
F
F