Kawasaki disease: clinical spectrum of 88 patients in a high-prevalence African-American population

J Natl Med Assoc. 2008 Jan;100(1):28-32. doi: 10.1016/s0027-9684(15)31171-8.

Abstract

Kawasaki disease (KD) is a systemic vasculitis that predominantly affects infants and young children. Asian race has been described as an important factor for the development of this disease. We reported our experience in a cohort of patients with KD. Clinical and laboratory data from initial presentation and follow-up visits were reviewed in 88 patients with KD treated at Children's Hospital of New Orleans between March 1993 and November 2004. Forty-nine (56%) patients were African American, 35 (40%) Caucasian, two (3%) Asian and two (3%) Hispanic. Coronary artery aneurysms (CAAs) were detected in 15 (17%) patients. CAAs were less frequent in African-American patients compared to Caucasians [relative risk (RR)=0.2, 95% CI: 0.04400-0.8405, p=0.0164]. Eighty-three patients responded to one dose of intravenous human immunoglobulin (IVIG), five patients responded to a second infusion of IVIG, and two who were IVIG resistant responded only following methylprednisolone pulse. Hemoglobin (Hb) levels of <10 g/dl and presence of polymorphic rash were significantly correlated with development of CAAs. No deaths were observed.

MeSH terms

  • Child, Preschool
  • Cohort Studies
  • Coronary Aneurysm / diagnosis
  • Coronary Aneurysm / etiology
  • Female
  • Hemoglobins / analysis
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Mucocutaneous Lymph Node Syndrome / complications
  • Mucocutaneous Lymph Node Syndrome / diagnosis*
  • Mucocutaneous Lymph Node Syndrome / drug therapy
  • Racial Groups*

Substances

  • Hemoglobins
  • Immunoglobulins, Intravenous