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Open AccessArticle

Clinical Manifestations of Kawasaki Disease at Different Age Spectrum: A Ten-Year Study

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Pediatric Rheumatology Unit, Children’s Hospital José Alencar, Brasilia 74083-330, Brazil
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School of Medicine, Brasilia University Center—UNICEUB, Brasilia 70790-075, Brazil
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Interdisciplinary Laboratory of Biosciences, School of Medicine, University of Brasilia, Brasilia 70910-900, Brazil
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Post-graduate Program in Medical Sciences, School of Medicine, University of Brasilia, Brasilia 70910-900, Brazil
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Post-graduate Program in Health Sciences, School of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
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Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia 70910-900, Brazil
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Department of Statistics, University of Brasilia, Brasilia 70910-900, Brazil
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(4), 145; https://doi.org/10.3390/medicina56040145 (registering DOI)
Received: 19 February 2020 / Revised: 17 March 2020 / Accepted: 18 March 2020 / Published: 25 March 2020
Background and objectives: The present study is the first known in Latin America to enroll a substantial number of Kawasaki disease (KD) patients with an extended follow-up. This study aimed to: (1) to expose the difficulties and delays in the diagnosis of KD in a developing country, (2) to describe and correlate the clinical features of this disorder with the children’s age at the time of disease onset, (3) to correlate the frequent lack of early diagnosis with a delayed application of appropriate treatment, and (4) to describe the outcome and eventual recurrences of KD in our region. Materials and Methods: Three hundred and one participants (183 males and 118 females) included in the study were diagnosed and, subsequently, clinically followed for ten years (January 2007 to December 2016) at the Pediatric Rheumatology Walk-in Clinic of the Children’s Hospital of Brasilia. Results: Episodes ranged from four months to two years. This rate of recurrence was well-above that disclosed by previous reports. Delay in diagnosis, in all age groups, caused an undesirable delay between the disease onset, the final diagnosis, and the administration of intravenous immunoglobulin (IVIG). KD recurred in 25 (8.3%) of the children during the first three years of follow-up. In seven patients, KD recurred twice, with an interval between episodes ranging from four months to two years. Conclusions: This rate of recurrence was well-above that disclosed by previous reports. In Latin America, aside from a handful of physicians and researchers, KD is being ignored. There is a pressing need to educate primary health care physicians and bring awareness to the fact that KD is not an exotic condition that affects only the Asian populations but a disorder that already exists among us and that frequently results in severe consequences. View Full-Text
Keywords: Kawasaki disease; self-limited vasculitis; coronary artery lesions; global health issue Kawasaki disease; self-limited vasculitis; coronary artery lesions; global health issue
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Medeiros R. de Magalhães, C.; Coutinho de Almeida, F.; Gandolfi, L.; Pratesi, R.; Ribeiro de M. Alves, N.; Selleski, N.; Zandonadi, R.P.; Nakano, E.Y.; Pratesi, C.B. Clinical Manifestations of Kawasaki Disease at Different Age Spectrum: A Ten-Year Study. Medicina 2020, 56, 145.

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