Supervisors info:
Αθανάσιος Μίχος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δέσποινα Μπριάνα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Βασιλική Συριοπούλου, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
BACKGROUND: Kawasaki disease in an acute, self-limited febrile illness of childhood, mainly occurs in children under the age of 5 years. KD is characterized by systemic inflammation in all the medium-sized arteries and due to the predominant complications in the coronary arteries, it constitutes the leading cause of acquired heart disease in these children. The pathogenesis of KD remains unknown. Although, recent studies strongly support infection with a viral agent that usually results in asymptomatic infection, causing KD in a small subset of genetically predisposed children. The American Heart Association currently recommends treatment with a single, high dose of intravenous globulin and high-dose aspirin during the acute phase of the illness. If untreated, approximately 15–25% of children develop coronary artery aneurysms, which may lead to myocardial infarction and death. On the contrary, immediate initiation of therapy diminishes the size of aneurysms from 25% to 4%.
AIM: The assess of epidemiological characteristics, clinical symptoms and laboratory findings predisposing to cardiovascular complications in children hospitalized with typical and atypical KD.
METHODOLOGY: This is a retrospective analysis of the medical data from children with KD, admitted to a tertiary pediatric hospital in Athens, from January 2011 to December 2018. The KD diagnosis and the definitions for cardiovascular complications was based on the American Heart Association criteria (2017).
RESULTS: 61 children younger than 14 years were diagnosed with KD, 31 children (50,8%) were considered as typical KD, while 30 children (49,2%) were atypical cases. The presentation of cases showed a distribution in early winter (December 11,5% ) and spring (March 16,4%, May 11,55%). An elevated SGPT concentration during hospitalization was associated with cardiovascular complications (P=0,027) and was more common in typical KD than in atypical (P=0,019). From the atypical KD children 46,7% were diagnosed with cardiovascular complications in relation to 38,7% of typical, but with no statistical difference(P=0,54).
CONCLUSIONS: An increased percentage of atypical KD cases comparing with other studies was diagnosed during the study period. Cardiovascular complications were more prevalent in the atypical than the typical KD cases.
Keywords:
Coronary arteries, Kawasaki syndrome, Atypical Kawasaki, Epidemiology, Cardiovascular complications
