Abstract 79: Is Harada Score a Useful Tool in Mexican Childrens with Kawasaki Disease?

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Abstract

Background/Purpose: In developed countries Kawasaki disease (KD) is the most common cause of acquired heart disease in childhood. Haradascore is one of the most used predictive tool for coronary arteries aneurysms (CAA) development in KD. The aim of the study is to describe clinical data, treatment, and to assess the Harada score in Mexican patients with KD.

Methods: We retrospectively indentified all patients evaluated at Hospital Infantil de Mexico Federico Gómez during a 6-yearperiod between 2008 and 2014. We reviewed demographic, clinical, laboratory, echocardiographic, and treatment data;and Harada scores were derived to evaluate efficacy in predicting risk for CAA.

Results: In our Institution 34 cases were reported during the study period, 16 (47.1%) males, and median age of 36 (8 - 120)months. Incomplete KD was diagnosed in 6 (17.6%) cases with no significant differences in demographic data, but with alower accuracy in establishing diagnosis at admission compared with complete presentations (100% vs 66.7%, P = 0.027).Most of the patients (76.5%) received at least one antibiotic prior to admission to our Hospital.

Patients presented with history of 6 (4 - 16) days with fever and conjunctivitis. Significant differences were observed between complete and incomplete presentations regarding oral changes (100% vs 66.7%, P = .027), strawberry tongue (92.9% vs 33.3%, P = .004), pharyngitis (100% vs 33.3%, P < .001), and rash (71.4% vs 16.7%, P = .021). No significant differences were observed in laboratory results. Seven (20.6%) echocardiograms werereported with CAA, one of them found valve insufficiency, and none identified effusion. Harada score was positive in 23 (67.6%) patients, with high sensitivity (85.7%) and low specificity (37%), OR 1.36 (CI95% 0.89 - 2.06, P = .384).

In total, 32 (94.1%) patients received intravenous immunoglobulin (IVIG). Retreatment with IVIG was given in 3 (8.8%) and steroid treatment in 1 (2.9%) patient. All of the patients received aspirin.

Conclusions: This study revealed a high incidence of CAA in our population, added to lack of suspicion and antibiotic overuse. As in Japanese and US population, Harada score is a good screening tool to identify risk for CAA development in Mexican patients.

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