Introduction:

Kawasaki disease (KD) is an acute vasculitis that predominantly affects children, its main complication is the development of coronary artery aneurysms in ≈25% of untreated cases.

Objective:

To describe the frequency of coronary involvement in patients (pts) diagnosed with KD and analyze risk factors for its presence.

Materials and methods:

This was a retrospective, descriptive study, that included pts <16 years who were hospitalized between 1996-2018 in the Institute of Tropical Medicine (IMT) with a discharge diagnosis of KD. The diagnosis of KD and the definition of coronary artery involvement was made based on the 2017 American Heart Association guidelines. Epidemiological, clinical, laboratory and treatment variables were analyzed between the groups with or without coronary artery involvement.

Results:

During the study period, 69 patients with KD were enrolled, of which 81.1% were under 5 years of age. 39 patients (56.5%) presented complete KD, while 30 patients (43.5%) presented incomplete KD. The echocardiogram was abnormal in 48 cases (69.5%), dilatation of the coronary arteries were detected in 19 cases (27.5%), and aneurysm in 7 patients (10%). The presence of leukocytes> 15000 / mm3 (p = 0.01; OR 3.69, 95% CI 1.32-10.27), thrombocytosis> 600000 / mm3 (p <0.05; OR 3.20, 95% CI 1.07-9.57) and ESR> 60 mm (p <0..01; OR 4, 95% CI 1.48-11-91) were associated with the presence of coronary artery abnormalities. The requirement for an additional dose of intravenous immunoglobulin was more frequent in the group of patients with coronary abnormalities (p <0.01; OR 5.57, 95% CI 1.64-18.77).

Conclusions:

This study allowed us to identify risk factors associated with coronary disease in our population, which can contribute to the adequate treatment of this group of patients.

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