Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Pediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom.
Pediatr Rheumatol Online J. 2023 Apr 3;21(1):30. doi: 10.1186/s12969-023-00805-y.
Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed countries with a variable incidence worldwide. Previous studies reported an unexpectedly high incidence of KD in the Canadian Atlantic Provinces. The goals of our study were to validate this finding in the province of Nova Scotia and to carefully review patients' characteristics and disease outcomes.
This was a retrospective review of all children < 16 years old from Nova Scotia diagnosed with KD between 2007-2018. Cases were identified using a combination of administrative and clinical databases. Clinical information was collected retrospectively by health record review using a standardized form.
Between 2007-2018, 220 patients were diagnosed with KD; 61.4% and 23.2% met the criteria for complete and incomplete disease, respectively. The annual incidence was 29.6 per 100,000 children < 5 years. The male to female ratio was 1.3:1 and the median age was 3.6 years. All patients diagnosed with KD in the acute phase received intravenous immunoglobulin (IVIG); 23 (12%) were refractory to the first dose. Coronary artery aneurysms were found in 13 (6%) patients and one patient died with multiple giant aneurysms.
We have confirmed an incidence of KD in our population which is higher than that reported in Europe and other regions of North America despite our small Asian population. The comprehensive method to capture patients may have contributed to the detection of the higher incidence. The role of local environmental and genetic factors also deserves further study. Increased attention to regional differences in the epidemiology of KD may improve our understanding of this important childhood vasculitis.
川崎病（KD）是发达国家儿童获得性心脏病的主要原因，其发病率在全球存在差异。先前的研究报告称，加拿大大西洋省份的 KD 发病率异常高。我们的研究目的是在新斯科舍省验证这一发现，并仔细审查患者的特征和疾病结局。
这是一项对新斯科舍省所有 2007-2018 年间诊断为 KD 的<16 岁儿童的回顾性研究。通过综合使用行政和临床数据库确定病例。使用标准化表格通过病历回顾收集临床信息。
2007-2018 年间，共诊断出 220 例 KD 患者；分别有 61.4%和 23.2%的患者符合完全型和不完全型疾病的标准。<5 岁儿童的年发病率为 29.6/10 万。男女比例为 1.3:1，中位年龄为 3.6 岁。所有在急性期诊断为 KD 的患者均接受了静脉注射免疫球蛋白（IVIG）治疗；23 例（12%）对首剂治疗无反应。13 例（6%）患者存在冠状动脉瘤，1 例患者因多发巨大动脉瘤死亡。
尽管我们的亚洲人口较少，但我们的人群 KD 发病率高于欧洲和北美的其他地区。这种综合的患者捕捉方法可能有助于发现更高的发病率。局部环境和遗传因素的作用也值得进一步研究。对 KD 流行病学的区域性差异的更多关注可能会增进我们对这种重要的儿童血管炎的理解。
