[Complications and course of Kawasaki disease in 23 patients].

OBJECTIVES

A comprehensive description of clinical data, cardiological complications, evolution and treatment of patients who were diagnosed with Kawasaki disease in our hospital is presented.

MATERIAL AND METHODS

A retrospective study of clinical and cardiological data, as well as laboratory tests collected from 23 patients who suffered from Kawasaki disease and were treated between January 1989 and December 1995 was performed.

RESULTS

The mean age of the patients was 3 years and 6 months of age, ranging from 5 months to 6 years old. The ratio male/female was 1.5/1. Clinical features were typical of the disease: persistent fever (100%), bilateral conjunctivitis (87%), changes in lips and oropharynx (100%), rash (91%), periungual desquamation (83%) and laterocervical adenopathy (74%). The diagnosis was delayed in 7 cases due to some symptoms that appeared as the beginning of the illness: hydrops of the gallbladder (one case), adenophlegmon (two cases), aseptic meningitis (two cases), diarrhoea (one case) and "sunburn-like" skin rash (one case). Five patients (22%) showed cardiological sequelae, three of them also had coronary artery aneurysms. One of these, whose diameter measured more than 8 mm, was several times complicated with coronary thrombus. Every patient was treated with salicylates and 19 of them were also treated with intravenous gamma globulins. As of December 1995, no deaths had been reported.

CONCLUSIONS

Whenever the first symptoms and the evolution of the disease are not classical, it is more difficult to diagnose the disease.