Coria-Lorenzo JJ, Sotelo-Cruz N, Ramírez-Bouchand D, Enríquez-Cisneros O, Díaz-Luna JL, Unda-Gómez JJ, Ramírez-Rivera R, Martínez-Medina L, Díaz-Toquero A, Jiménez-Juárez RN, Enciso-Peláez S, Gutiérrez-Ceniceros M, Reyes-López A

Language: Spanish
References: 9
Page: 154-158
PDF size: 271.69 Kb.

ABSTRACT

Introduction: The Kawasaki disease is an acute systemic inflammatory disease, being responsible for the most frequent cause of acquired heart disease and aneurysms in children. Its evolution includes three clinical stages (acute, sub-acute and convalescence). Material and methods: We conducted a multicenter, descriptive analysis; simple and accumulated frequencies were calculated, as well as percentages. This study included nine hospitals to know the clinical and epidemiological characteristics of the disease in Mexican children. Results: Of 182 files reviewed, three were eliminated by lacking echocardiogram, remaining 179; from those, 16 cases did not have any kind of rash at any time of the disease. Four corresponded to a classic or complete Kawasaki and twelve to the incomplete form. The age was between five months to 22 years, being 44% female and 56% male. The evolution of the disease at the time of diagnosis was on average of 10 days with a range of 5-22 and media of 9 days. There were nine cases with coronary aneurysm, 8 of them were incomplete, and 5 of these had a low platelet count. Analysis: With regard to diagnosis of Kawasaki disease according to major clinical criteria in addition to the fever, patients with 3 and 2 criteria were the most relevant, 37 and 31%, respectively; followed by those who showed 4 criteria (25%); and only one patient with a single criterion. Conclusions: The patients with unexplained fever, high acute-phase reactants and conjunctivitis should alert the physician to suspect KD even if they do not show any rash.

REFERENCES

1. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of fingers and toes in children. Clinical observation of 50 patients. Jpn J Allergy. 1967; 16: 178-222. [in Japanese]

2. Kawasaki T, Kosaki F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974; 54: 271-276.

3. Dawman L, Kabra SK. Kawasaki disease: unusual clinical manifestations. Indian J Pediatr. 2014; 81(4): 325-327.

4. Bayers S, Shulman ST, Paller AS. Kawasaki disease: Part I. Diagnosis, clinical features, and pathogenesis. J Am Acad Dermatol. 2013; 69: 501.e1-e11.

5. Coria JJL. Enfermedad de Kawasaki. Grupo Red para la Vigilancia y Prevención de Enfermedad de Kawasaki en México. Rev Enf Inf Ped. 2012; 27(102): 213-214.

6. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004; 110: 2747-2771.

7. Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodó X, Uehara R et al. Seasonality of Kawasaki disease: a global perspective. PLoS One. 2013; 8(9): e74529.

8. Research Committee on Kawasaki Disease. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo, Japan: Ministry of Health and Welfare; 1984.

9. Harada K, Yamaguchi H, Kato H, Nishibayashi Y, Ichiro S, Okazaki T et al. Indication for intravenous gamma globulin treatment for Kawasaki disease. In: Takahashi M, Taubert K, eds. Proceedings of the Fourth International Symposium on Kawasaki Disease. Dallas, Tex: American Heart Association; 1993: 459-462.