Characteristics of Kawasaki Patients in Kermanshah Hospitals During 1997-2002

Introduction: Kawasaki disease is a systemic vasculitis that usually involves children younger than 5 years old. Etiology is unknown and since there is no labaratory test to diagnose Kawasaki disease, the major diagnosis is based on clinical findings .The objective of this study was to determine incidence, complications, time of treatment and clinical manifestations in children with Kawasaki disease who were admitted to Razi and Shahid Fahmideh Hospitals in Kermanshah during 1997 to 2002.

Materials and Methods: This descriptive study was based on records of patients admitted to Razi and Shahid Fahmideh Hospitals from 1997 to 2002 suffering from Kawasaki disease.

Diagnostic criteria were: fever, skin rash, bilateral noninfectious conjunctivitis, erythema and desquamation of extremities, alteration in mucosa of mouth and pharynx. The total patients were 23(11 females & 12 males) and the variables for this study were age, sex, time of suffering, clinical manifestations, paraclinical findings , drug treatment and complications.

Results: Age range was from 8.5 months to  8 years. Male to female ratio was 1.09% Disease occurence was seen in spring and winter more than other seasons(43/4% & 26/08% respectively). 86/9% of all patients had full criteria but 13% of them were atypical. Fever was seen in 100%, extermity involvement in 22 patients (95/6%), conjunctivitis in 21 patients( 91.3%) , involvement of upper respiratory airways in  20 patients (86.9%), skin rashes in 16 patients (69.5% ), and neck lymphadenopathy in15 patients (65.2%). Echocardiography was done in 21 cases and in 4 cases (17.3%)
coronary artery aneurysm was reported. 19 patients (82.6%) were treated with IVIgG. 3 patients (15/7%) developed aneurysm and from 4 patients who were not treated with IVIgG  1 patient (25%) developed anurysm.

Conclusion: Coronary artery aneurysm is a significant complication in Kawasaki disease. Attention to clinical manifestations and diagnosis in acute phase and treatment with IVIgG can reduce risk of coronary artery aneurysm.