Abstract 209: Kawasaki Disease In Infants. Experience in a Third Level Facility in Mexico City

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Abstract

Background: Kawasaki disease (KD) is an acute febrile vasculitis of unknown origin. KD represents the most common cause of acquired heart disease in children in developed countries. Worldwide KD is uncommon in infants (younger than 3 months of age), and in Mexico there are few reports of KD in this group of age.

Objective: To describe the clinical features, laboratory parameters, the incidence of coronary aneurysms, treatment employed and the outcome of infants with KD in a third level facility in Mexico City

Methods: A retrospective and descriptive study was performed on children younger than 3 months of age with KD from August 1995 to August 2014. We analyzed gender, age, clinical manifestations, hemoglobin levels, leucocyte count, platelet count, ESR, CRP, albumin, sodium, potassium, AST, ASL, time from the onset of the symptoms to diagnosis, treatment used, the development of CAA and outcome in the acute phase of the disease.

Results: Eight infants were diagnosed with KD during the study period. The median age at diagnosis was 2.5 months (range 2-3 months). Five patients were male (62.5%). The median from the onset of the clinical manifestations to diagnosis of KD was 14 days (range 4 to 26 days). All patients received medical consultations (range 1 to 7) prior to diagnosis. An incomplete form of KD was present in 4 patients. Five patients (62.5%) received IVIG. Four patients (40%) received steroids and low dose aspirin. Five of our patients developed coronary aneurysms, all of them were categorized as giant aneurysms (Z-Score > 10); one of these patients died of cardiogenic shock in the acute phase of the disease.

Conclusions: In Latin American countries are few reports of KD in infants. We present our experience in infants with KD. Near two thirds of our patients developed coronary aneurisms; most of the patients with coronary aneurisms were associated with late diagnosis and therefore late onset treatment.

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