title: [Kawasaki disease: a case report from Madagascar].
abstract: Kawasaki disease is recognized as a leading cause of acquired heart disease in some Western countries. It has rarely been described in Africa. The purpose of this report is to describe a case of typical Kawasaki disease in a 9-year-old girl from Madagascar. Despite administration of acetylsalicylic acid upon admission (80 mg/kg/d), the patient developed pancarditis on day 6 that was complicated by acute left heart failure confirmed by echocardiography. A clearcut improvement was obtained using prednisone (2 mg/kg/day) before treatment using intravenous immunoglobulins imported from France on day 11 (0.5 mg/kg/day for 5 days). Echocardiography on day 24 demonstrated a 5 mm aneurysm in the left coronary artery. Acetylsalicylic acid was discontinued at 6 months after control examinations at 4 and 6 months demonstrated disappearance of the aneurysm. In addition to further documenting the presence of Kawasaki disease in Madagascar, this case report illustrates the difficulty of management in a developing country.
authors.affiliation: Service de Pédiatrie et Néonatologie, Centre Hospitalier de Soavinandriana, Antananarivo, Madagascar. domohina.rakotovao@yahoo.fr
authors.forename: D N
authors.initials: DN
authors.lastname: Rakotovao
authors.forename: R M
authors.initials: RM
authors.lastname: Miandrisoa
authors.forename: V L
authors.initials: VL
authors.lastname: Ramanitrarivo
authors.forename: G
authors.initials: G
authors.lastname: Rakotonirina
authors.forename: S P
authors.initials: SP
authors.lastname: Rakotomamonjy
authors.forename: P
authors.initials: P
authors.lastname: Imbert
mesh_terms: D000328:Adult; D003906:Developing Countries; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008270:Madagascar; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000628:therapy*; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D011241:Prednisone