Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_5539108787EF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne.
Périodique
Frontiers in pediatrics
Auteur(s)
de La Harpe M., di Bernardo S., Hofer M., Sekarski N.
ISSN
2296-2360 (Print)
ISSN-L
2296-2360
Statut éditorial
Publié
Date de publication
2019
Peer-reviewed
Oui
Volume
7
Pages
11
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Kawasaki disease is an acute vasculitis with a particular involvement of the coronary arteries. Coronary artery aneurysms develop in 20% of untreated children. It has been shown that early treatment with intravenous immunoglobulins and aspirin decreases this risk to 5%, but the medium to long term prognosis of children with Kawasaki disease is still unclear. To determine the outcome of the disease and risk factors for poor evolution, we reviewed retrospectively the medical records of all patients with a diagnosis of Kawasaki disease at our Institution between 1981 and 2014. Among the 207 patients included in the study, 96 patients had coronary diameter anomalies (46.4%) at diagnosis and children with atypical ages for Kawasaki disease (<1 year or >10 year of age) were more often affected with aneurysms or dilatations. Eighty-four of them had complete regression of coronary aneurysms during the follow-up (87.5%) Absence of immunoglobulins in the acute phase was associated with less regression rate (57.1 vs. 92.2%), and boys had greater z-scores at last echocardiography, statistically significant for the left anterior descending artery. We found rare complications after the acute phase documented in our patient charts (only 3.8%). Recurrence of the disease occurred in 5 children (2.4%) and myocardial ischemia in 3 patients (1.4%), all with initial coronary aneurysm. Conclusion: Medium to long term prognosis after Kawasaki disease is excellent. Boys, patients not treated with immunoglobulins or outside the usual age range are more at risk for an unfavorable outcome.
Mots-clé
Kawasaki disease, cardiac sequelae, complications, coronary aneurysm, follow-up, prognosis
Pubmed
Web of science
Open Access
Oui
Création de la notice
31/03/2019 15:40
Dernière modification de la notice
20/08/2019 15:09
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