Abstract 204: Risk factors for development of coronary artery aneurysms in Kawasaki disease in Mexican Children

Abstract

Background: Kawasaki Disease (KD) is an acute febrile illness characterized by systemic vasculitis of unknown etiology. Cardiac sequelae, such as coronary artery aneurysms (CAA), are one of the most important aspects of this disease. Actually, it is the major cause of acquired heart disease in developed countries but its frequency in Mexico is still unknown. Objective: To establish the risk factors for development of coronary artery lesions in children with KD who were treated at the Instituto Nacional de Pediatria in Mexico City. Material and Methods: An observational, comparative, retrospective case-control study of all patients diagnosed with KD in our Institution from August 1995 to May 2014. We reviewed the medical records and analyzed gender, age, weight, height, clinical manifestations, time from the onset of the symptoms to diagnosis, hemoglobin, leucocyte count, platelet count, ESR, C-RP, albumin, sodium, AST ASL, treatment used and the development of coronary artery aneurysms. Results: We studied 384 cases of KD, 68% were male with a mean age at diagnosis of 39.02 ± 36.55 months. The mean duration of fever from the onset of the symptoms to diagnosis was 9.4 ± 5.79. An incomplete form of KD was diagnosed in 69 patients (19.4%). 150 patients developed CAA (39%). Multivariate analysis for CAA showed that younger age (p < 0.028) prolonged time to diagnosis (p < 0.001), central nervous system manifestations (p < 0.008) anemia (p < 0.001) leukocytosis (p < 0.005), thrombocytosis (p < 0.041) and elevated C-RP (p < 0.022) were the most important risk factors for development of CAA in our patients. Conclusions: This is the largest series of KD in Mexico, with more cases diagnosed in recent years, so it appear that the disease is more common than initially thought. Also, the frequency of CAA is greater than the reported in the literature, but it appears that is related to a delayed diagnosis and treatment.