Pediatric Rheumatology Online Journal → July 2003 → Vasculitides → Kawasaki Disease → Abstract #132
OUTCOME IN KAWASAKI DISEASE: A LONG - TERM FOLLOW UP STUDY
R. Scuccimarri,1,2 M. J. Beland,1,2 K. N. Watanabe Duffy,1,2 L. Jutras,1,2 C. Rohlicek,1,2 A. Dancea,1,2 B. Love,1,2 M. Cortopassi,1 I. Morin,1 R. Platt,1,2 C. M. Duffy.1,2
Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada; 2McGill University, Canada
Background: While there are clear guidelines regarding short-term follow up in Kawasaki Disease (KD), there are no guidelines for long-term follow up. Patients with and without coronary artery lesions (CAL) may be at risk for late cardiac complications because all patients with KD have had some degree of vascular damage. Since 1985, we have followed prospectively a large cohort of patients with KD treated in the acute phase with IVIG and low dose ASA. Here we describe their outcome.
Methods: All patients admitted at the MCH with a diagnosis of KD between January 1985 and December 1999, who were treated with low dose ASA and IVIG, who either fulfilled diagnostic criteria or were deemed to have atypical or incomplete KD, and who had a minimum follow up of 2 years, were included. Patients were brought back for a medical visit which included a questionnaire, physical examination, ECG, and 2D echocardiogram.
Results:
Of the 221 patients who fulfilled inclusion criteria, 149 have participated thus
far. There are 96 boys and 53 girls (1.8:1) with a mean age at diagnosis of 3.13
years (range 0.18 - 13.04). Mean age at follow up was 11.15 years (3.29 - 23.25)
with a mean follow up of 8.02 years (2.18 - 16.91). At presentation, 122 (81.88%) fulfilled KD diagnostic criteria, 24 (16.11%) had incomplete KD, and 3 (2.01%) had atypical KD. On early follow up (up to 8 weeks), 11 (7.38%) had CAL, and 25 (16.78%) had other early abnormalities. CAL regression occurred in all but one. At long-term follow up, 8 (5.37%) were smokers, and 12 (8.05%) had symptoms requiring further investigations. Preliminary data suggest that there are 9 with CAL and 7 with other cardiac abnormalities. Most are new findings and all need further review.
Conclusion: New cardiac abnormalities were noted on long-term follow up. The significance of these abnormalities is yet unclear however, these results further support the need for long-term follow up of all patients with KD.