P23 Prognostic impact of the treatment on the coronary sequelae to children in kawasaki disease

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Abstract

Objectives

Assessment of evolutive particularities of coronary aneurysms lesions correlated with the treatment received.

Method

We monitored over a period of 10 years, 5 children (0–10 years) diagnosed with Kawasaki disease. Evaluation of patients included clinical exam, electrocardiogram, coronary ultrasound, exploring lipid metabolism, the inflammatory markers.

Results

Complete form of the disease in 4/5 cases, incomplete form in 1/5 cases; 5/5- have at onset ECG changes; the coronary aneurysms were present in all patients predominantly in the left coronary: unique 2/5 cases, multiple 3/5 cases; medium-sized (5–6 mm) 4/5 cases, large (8 mm) 1/5 cases. After 1 year: complete aneurysms regression 1/5, numerical 1/5, maintains coronary ectasia 1/5, stationary 2/5 cases. After three years: total aneurysms regression 3/5, coronary ectasia 1/5, stationary 1/5. According to Koren risk score the patients received individualised intravenous immunoglobulin, aspirin, methyl prednisolone. 1 child wich developed the symptoms ’asthma-like’ to aspirin it was replaced with dipyridamole.

Conclusions

Patients with at increased risk score who received methyl-prednisolone in the treatment although they have developed the coronary artery aneurysms they were small and declining rapidly in the evolution. Caution is recommended in the use of aspirin in patients with atopic risk. Koren risk score may guide appropriate treatment for each patient and is well correlate with the risk of developing coronary artery aneurysms in Kawasaki disease in children.

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