Abstract
KAWASAKI DISEASE IN CHILDREN PRESENTED TO MAKASSED GENERAL HOSPITAL: A SEVENTEEN YEAR REVIEW

Mona F. Zaarooura*, Bassem Abou Merhi, Ziad Naja and Amal Naous

ABSTRACT

Background: Kawasaki disease is an acute febrile illness of early childhood, with about 80% of cases occurring between 6 months and 5 years. It is characterized by fever lasting at least five days and a constellation of clinical features that are used as diagnostic criteria. Objectives: To describe the epidemiologic, clinical and laboratory characteristics of Kawasaki disease in children presented to Makassed general hospital between 2000 and 2017 and to compare between the 2 types of Kawasaki disease, typical and atypical, aiming to predict factors likely to affect the outcome of the disease in terms of cardiac complications especially coronary artery aneurysm. Methods: This is a retrospective population-based descriptive study using hospital discharge records of Kawasaki disease diagnosis of children younger than 18 years of old in Makassed General Hospital between 2000 and 2017. Results: Between 2000 and 2017, Ninety Eight (98) patients were diagnosed as having Kawasaki Disease, of which 44% (n=43) fulfilled the complete criteria classified as Typical Kawasaki disease and 56% (n=55) were classified as atypical Kawasaki. 75.5% (n=74) of patients were aged between 1 and 5 years and 70.4% (n=69) were of male gender. 13.3% (n=12) of patients had positive EBV-IgM and 12.2% (n=11) had positive Mycoplasma titer. 5.5% of patients with atypical KD (n=3) and 4.7% of patients with typical Kawasaki (n=2) had dilated coronary artery on echocardiography (p=0.21) and 3.6% of patients (n=2) who had atypical Kawasaki disease, had coronary ectasia on echocardiography. All our patients received IVIG for treatment with 100% response to treatment. And finally the number of patients diagnosed with Kawasaki disease increased from 2 patients in 2000 to 16 cases in 2015, 15 cases in 2016 and 13 cases in 2017 which may attribute to increased awareness for the early diagnosis of the disease. Conclusion: Kawasaki Disease has been more frequently diagnosed over years in our institution. It is more prevalent in males than in of females between 1 and 5 years of age. Infants less than one year have few clinical features of the disease thus diagnosed with atypical Kawasaki and are at higher risk of having coronary artery lesions. Moreover, patients with KD may have concomitant infection that does not preclude the diagnosis of Kawasaki disease.

Keywords: Kawasaki Disease, Typical KD, Atypical KD, Coronary artery lesions.


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