Features of the course, diagnosis and treatment of kawasaki disease in st. Petersburg

Abstract

Kawasaki disease (KD) is acute systemic vasculitis of unknown etiology. Approximately half of patients develop coronary artery changes with a range of severity from asymptomatic coronary artery dilatation to giant coronary artery aneurysms with, myocardial infarction, and sudden death. To date there is no official data on the incidence of KD in Russia. Objective: to analyze the experience in diagnosing and treating KD in Saint Petersburg. Patients and methods. The retrospective study included data on 52 children (31 boys, 21 girls) who were hospitalized with a diagnosis of KD between January 2011 and December 2017. Data are represented by median and extreme values. The age of the children was 2 (0,3; 6) years; of them 12 (23%) patients were under the age of 1 year. The children were hospitalized on 5 (1; 14) days of disease onset; KD was diagnosed on 9 (3; 52) day of the disease. Results. Before 10 days of the disease, intravenous immunoglobulin (IVIG) therapy was performed in 24 (46%) children, one of them received IVIG before disease day 5 (on day 3), but without effect. On disease days 11-30 (immediately after diagnosis), 20 (39%) children were prescribed with IVIG. Ultrasonography revealed coronary artery lesions in 21 (40%) patients. Out of the 52 children followed up, one baby who fell ill at the age of 3 months and received IVIG died on day 30 of the disease. Conclusion. Currently, there continues to be a delayed diagnosis of KD. IVIG therapy was effective, especially in cases of timely diagnosis. It is necessary to increase awareness of KD among clinicians and ultrasound diagnosticians.