Abstract
Kawasaki´s disease has become a well known disease in Chilean children. Nevertheless, continuing high rates of coronary artery aneurysms (CAA) have been reported in this population, suggesting lack of efficacy of the treatment with intravenous immunoglobulin (IVIG). The aim of this study was to examine the clinico-epidemiological features of 60 children discharged from the Roberto del Río Children´s Hospital between january 1987 and may 1999. Age, sex, fever, time to diagnostic and treatment were studied. Results: 12 patients (20%) presented with CAA, all of them in typical cases, whereas no such complication occurred in the incomplete cases. The prevalence of Kawasaki´s disease in the northern area of Santiago is 3.9 per 100,000 in children less than 5. Failure to detect the disease, 60% of diagnoses made after the fifth day (range 6-16), treatment delay (median 8 days, range 5-15) as well as selection bias for deciding therapy may explain the apparent inefficacy of IVIG, since doses did not exceed 2 000 mg/kg. These figures have not shown significant changes over the last 10 years. Conclusion: Possible clinical pitfalls in diagnosis of KD are considered and proposals to improve its detection and timely treatment are suggested.
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Copyright (c) 2001 Revista Chilena de Pediatría