Cardiac complications in children with Kawasaki disease in our own experience

Abstract

Background: Kawasaki disease is the most common cause of acquired heart disease in children in developed countries. The incidence of Kawasaki disease varies from 180 in Japan through 20 in United States to 5–8 in the European countries per 100,000 children younger than 5 years of age.

Aim: To evaluate cardiac complications in children hospitalised with Kawasaki disease.

Methods: Retrospective analysis of the medical records of patients hospitalised with Kawasaki disease in the Specialist Mother and Child Healthcare Facility in Poznan (Poland) in 2008–2014. The diagnosis was based on the American Heart Association criteria.

Results: Study group included 30 patients (25 boys and 5 girls). The mean age was 49 months; 21 (70%) children were younger than 5 years of age. All patients had oral mucosal lesions, while an elevated leukocyte count was observed in a minority of patients. Cardiac involvement was detected in 18 (60%) patients, aneurysms in 4 (13.3%) patients, coronary artery dilatation in 6 patients, pericarditis in 6 patients, mitral regurgitation in 3 patients, and aortic regurgitation in 2 patients. In 5 children, more than 1 cardiac abnormality was detected. During 12 months of follow-up, coronary artery dilatation resolved in 5 children, and 1 patient developed aneurysm.

Conclusions: Our findings suggest that Kawasaki disease should be considered in the differential diagnosis of children with prolonged fever. During the acute stage of the disease, children with Kawasaki disease require regular cardiac evaluation, and long-term care is needed when cardiovascular complications occur. A central case reporting system to monitor all cases of Kawasaki disease in the Polish paediatric population should be introduced.