Coronary artery lesions in Kawasaki Disease

Kawasaki disease (KD) is an acute vasculitis of unknown etiology that frequently occur in childhood and young children and may lead to coronary arteries aneurysm (CAA). Treatment can lower the risk of development of giant aneurysm and is based on the administration of IGIV, aspirin and may need some adjunctive therapies. Methods In a retrospective study ruled between January 2014 and December 2018, we enrolled 49 children who were diagnosed with complete or incomplete Kawasaki disease in the internal-medicine pediatrics service of Ibn Rochd Hospital. Results 49 cases of Kawasaki disease were included, of which 59.2 % of boys and 40.8% of girls. Mean age was 31.39 months. 23 cases were diagnosed with complete KD. Oral cavity changes were present in 89.8% of all patients. Bilateral nonexudative conjonctival injection were found in 87.7% of cases. 43.9% of children had cervical lymphadenopathy, while 71.4% of them presented a polymorphous rash. Erythema of the extremities was found in 57.1% of cases. Inflammatory blood test revealed a mean value of 72.80 mm for vs. and 141.3 mg/L for CRP. All the patients underwent echocardiography at admission, revealing 28.5% of coronary arteries dilatation and 6% of coronary artery aneurysm. 46 patients received a single dose of IGIV and anti-inflammatory dose of aspirin with good evolution. 3 patients received a secondary dose of IGIV, and one of them required administration of anakinra. 72 h was the average time for defervescence. The vs. was positively correlated to coronary artery abnormalities in our series with a p value of 0.022. Control echocardiography was ruled out 6 weeks after admission, and revealed that 37.5% of coronary artery abnormalities disappeared, 43.5% regressed, 6.5%remained stable and 12.5% developed giant aneurysms. Conclusion Despite KD remains a poorly understood pathology, a rapid treatment and follow up can improve the prognosis and lower associated complications.