Kawasaki Disease: An Overview of 16 Years Experience At University Hospital of Algarve

Introduction: Kawasaki disease (KD) is one of the most common childhood vasculitis although its aetiology still remains unknown. It is a systemic inflammatory illness that particularly affects medium-sized arteries, especially the coronary arteries. The most feared complications include aneurysms and ischemic disease. Most cases occur in children younger than five years and rarely in those younger than six months.

The aim of this study was to evaluate the experience of this clinical entity at the main University Hospital of Algarve.

Methods: A retrospective study was performed through the analysis of epidemiological, clinical, laboratory and echocardiographic data of hospitalized KD cases between January 2004 and June 2019.

Results: A total of 22 cases were obtained. The ages ranged from 3 months to 8 years, with a median of 22 months, and subjects were predominantly male. There was a higher incidence in the months of June and December. At presentation, the majority had exanthema, ocular and mucosal involvement. The time of fever prior to diagnosis ranged from 1 to 15 days, with an average of 6 days. All had an echocardiogram, 8 had echographic alterations, of which 6 had aneurysms. All patients started treatment with immunoglobulin until the 10th day of illness, except for three patients who had a late diagnosis. They also all started acetylsalicylic acid therapy. The length of hospitalization ranged from 2 to 21 days, with an average of 9 days. Half of the patients will continue to be followed by pediatric cardiologist, and there were no deaths. Three of the six cases of aneurisms still have some degree of coronary dilatation and one patient underwent cardiac catheterization.

Conclusion: KD is known for its cardiovascular complications and is the leading cause of acquired heart disease in developed countries. An early diagnosis is critical to achieve optimal treatment results and a better outcome.