Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne

Frontiers in Pediatrics

article

Marion de La Harpe¹  Stefano di Bernardo²  Michaël Hofer³  Nicole Sekarski² 

[1] Pediatric Cardiology Unit, University of Lausanne;Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV);Pediatric Rheumatology Unit, University Hospital of Lausanne (CHUV)

关键词: Kawasaki disease;    coronary aneurysm;    complications;    cardiac sequelae;    follow-up;    prognosis;   

DOI  :  10.3389/fped.2019.00011

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Kawasaki disease is an acute vasculitis with a particular involvement of the coronary arteries. Coronary artery aneurysms develop in 20% of untreated children. It has been shown that early treatment with intravenous immunoglobulins and aspirin decreases this risk to 5%, but the medium to long term prognosis of children with Kawasaki disease is still unclear. To determine the outcome of the disease and risk factors for poor evolution, we reviewed retrospectively the medical records of all patients with a diagnosis of Kawasaki disease at our Institution between 1981 and 2014. Among the 207 patients included in the study, 96 patients had coronary diameter anomalies (46.4%) at diagnosis and children with atypical ages for Kawasaki disease (10 year of age) were more often affected with aneurysms or dilatations. Eighty-four of them had complete regression of coronary aneurysms during the follow-up (87.5%) Absence of immunoglobulins in the acute phase was associated with less regression rate (57.1 vs. 92.2%), and boys had greater z -scores at last echocardiography, statistically significant for the left anterior descending artery. We found rare complications after the acute phase documented in our patient charts (only 3.8%). Recurrence of the disease occurred in 5 children (2.4%) and myocardial ischemia in 3 patients (1.4%), all with initial coronary aneurysm. Conclusion: Medium to long term prognosis after Kawasaki disease is excellent. Boys, patients not treated with immunoglobulins or outside the usual age range are more at risk for an unfavorable outcome.

【 授权许可】

CC BY