Introduction:

Kawasaki disease is an acute, febrile and self-limiting vasculitis that may be complicated by cardiovascular changes. Its diagnosis is based on clinical criteria. Although effective treatment is available, it is the leading cause of acquired heart disease in children in developed countries.

Objectives:

to assess the prevalence of coronary artery abnormalities in paediatric patients diagnosed in our area, and the demographic, clinical and laboratory characteristics of the population under study, describing the risk factors for coronary involvement in children with Kawasaki disease.

Methods:

we performed a retrospective review of the medical records of children given a diagnosis of Kawasaki disease between January 1997 and December 2016 at the Hospital Clínico San Carlos (Madrid, Spain). We defined Kawasaki disease as the presence of the clinical criteria proposed for its diagnosis by the American Academy of Pediatrics in 2017.

Results:

cases of Kawasaki disease were most frequent in the winter (n = 13; 56.5%), in girls (n = 12; 52.2%) and in children aged 5 years or less (n = 18; 78.3%). Patients presented with fever (n = 23; 100%) and changes in the oropharyngeal mucosa (n = 21; 91.3%), with elevation of C-reactive protein and the erythrocyte sedimentation rate (n = 20; 86.95% and n = 13; 86.6%). Treatment consisted of intravenous immunoglobulin (n = 22; 95.7%) and acetylsalicylic acid at anti-inflammatory doses (n = 22; 95.7%) or antithrombotic doses (n = 20; 87%). Three patients (13%) developed coronary artery abnormalities that eventually resolved.

Conclusions:

in our cohort, the prevalence of coronary complications was similar to the prevalence reported for Spain and higher than the prevalence reported in international studies. The main risk factors for coronary artery abnormalities were delays in diagnosis or treatment, a white blood cell count greater than 12 000 cells/µl, a serum level of C-reactive protein greater than 3 mg/dl and thrombocytosis.

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