Abstract 213: Caracteristics of Kawasaki Disease in Chile: Temuco′s experience
Kawasaki Disease (KD) is a vasculitis mainly affecting children under two years old and harms arterial vessels (especially coronary) causing dilatation, aneurysms and eventual myocardial complications. Though etiology is unknown, a relationship with an infectious agent is suspected.
Diagnosis is doing by clinical criteria and laboratory support. KD cases reported in Latin America go along abscence of management protocols and it is not considered notifiable disease. In order to contribute to a greater understanding of this disease, a retrospective - descriptive analysis of 75 patients diagnosed with KD at the time of discharge was carried out from January 2005 to August 2014 at Hospital Dr.Hernán Henríquez Aravena, Temuco, Chile. Information was tabulated in Microsof Office Excel 2007 and a statical analysis were performed using STATA 11.0 program.
Average age 2 years 7 months (range 2 months to 17 years). Sex Male/Female 49%/51%. Prior consultations 85% (64/75). Initial diagnosis KD 51% (38/75). Fever 100% (75/75), 64%(48/75) about 39 ° C. Eye involvement 68% (51/75). Oropharyngeal erythema 87% (55/75). Strawberry tongue 40% (30/75). BCG erythema 19% (14/75). Rash 83% (62/75). Erythema/oedema of hands and foots 73% (55/75). Cervical adenopathy 41% (31/75). Irritability 55% (41/75). Leukocytosis 36% (27/75). Plaquetosis 69%(52/75) and periungual descamation 39% (29/75). Echocardiogram abnormal at startup 28% (21/75), (6/75)8% prior application of IVGG and 5%(4/75)remained with coronary involvement. A single dose of 2g/kg of Intravenous Gamma Globuline (IVGG) was administrated to 97%(73/75). Aspirin 50 mg/kg initial and 5 mg/kg during the following. A second dose of IVGG was required in 13% (10/75). Two patients were treated with anticoagulant for giant aneurysms and in one case, bilateral brachial aneurysms. Tipycal KD in 73% (55/75) and 27%(20/75) incomplete.
Further clinical suspicion is needed, because a high percentage of patients had coronary involvement at diagnosis. Those who received early IVGG coronary involvement were lower. Prominent among coronary involvement factors are extreme age, atypical or incomplete forms and high RCP. Needed be considered KD as a notifiable disease, considering the economic and social implications.
Author Disclosures: G. Soza: None. C. Cerda: None. A. Berkhoff: None. C. Lozano: None. A. Salgado: None.
- © 2015 by American Heart Association, Inc.