Kawasaki's disease in northern Italy

A multicenter retrospective study of 250 patients

Fernanda Falcini, R. Cimaz, G. B. Calabri, P. Picco, G. Martini, M. G. Marazzi, G. Simonini, F. Zulian

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective To evaluate (i) the clinical course and outcome in a cohort of 250 children affected with Kawasaki disease (KD) in northern Italy; (ii) the prevalence of coronary aneurysms and their correlation with treatment; and (iii) the prevalence of incomplete and atypical KD in the series as a whole. Results The male to female ratio was 1.8 to 1 and the median age at diagnosis 37 months. The majority of cases occurred in children under five years, with the youngest patient aged 51 days. Median duration of fever was 8 days; median erythrocyte sedimentation rate (ESR) and C Reactive protein (CRP) values, performed before any treatment, were 77 mm/1st h and 10.4 mg/dl respectively. Median haemoglobin (Hb) levels was 9.2 g/dl and median platelet (PTL) count 408,000/mm3. Out of 250 patients, 209 (83.6%) futfilled all criteria for the diagnosis of KD whilst 41/250 (16.4%) had an incomplete disease and 11/250 (4.4%) had an atypical onset. Fifty-four children (21.6%) were treated with aspirin alone (50-80 mg/kg/day, during the acute phase), while 196/250 (78.4%) were given aspirin (50-80 mg/kg day, during the acute phase and then 3-5 mg/Kg/day) and high-dose intravenous gammaglobulin (IVIG, 400 mg/Kg/day or 2 g/Kg/day). Coronary artery abnormalities, including aneurysms and dilatation, were reported in 7/54 patients (5 males and 2 females) who had not received IVIG and 53/196 patients (27 males and 26 females) who were treated with the IVIG in addition to aspirin. Other clinical manifestations included abdominal pain/diarrhoea (11), arthritis (10), hydrops of the gallbladder (8), disseminated intravascular coagulation (3), and hemiparesis (1). All patients except one infant are still alive. In most of the patients coronary alterations normalised, while in 20 patients they persisted for more than one year; in 12/20 patients they were permanent. Conclusion Pediatricians should be aware of the increasing number of children with atypical and incomplete KD, in order to diagnose and treat the disease even in the absence of all typical manifestations and to prevent coronary complications.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalClinical and Experimental Rheumatology
Volume20
Issue number3
Publication statusPublished - May 2002

Fingerprint

Mucocutaneous Lymph Node Syndrome
Italy
Multicenter Studies
Retrospective Studies
Intravenous Immunoglobulins
Aspirin
Coronary Aneurysm
Disseminated Intravascular Coagulation
Blood Sedimentation
Paresis
Gallbladder
Platelet Count
C-Reactive Protein
Abdominal Pain
Arthritis
Aneurysm
Dilatation
Diarrhea
Edema
Coronary Vessels

Keywords

  • Kawasaki's disease

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Falcini, F., Cimaz, R., Calabri, G. B., Picco, P., Martini, G., Marazzi, M. G., ... Zulian, F. (2002). Kawasaki's disease in northern Italy: A multicenter retrospective study of 250 patients. Clinical and Experimental Rheumatology, 20(3), 421-426.

Kawasaki's disease in northern Italy : A multicenter retrospective study of 250 patients. / Falcini, Fernanda; Cimaz, R.; Calabri, G. B.; Picco, P.; Martini, G.; Marazzi, M. G.; Simonini, G.; Zulian, F.

In: Clinical and Experimental Rheumatology, Vol. 20, No. 3, 05.2002, p. 421-426.

Research output: Contribution to journalArticle

Falcini, F, Cimaz, R, Calabri, GB, Picco, P, Martini, G, Marazzi, MG, Simonini, G & Zulian, F 2002, 'Kawasaki's disease in northern Italy: A multicenter retrospective study of 250 patients', Clinical and Experimental Rheumatology, vol. 20, no. 3, pp. 421-426.
Falcini, Fernanda ; Cimaz, R. ; Calabri, G. B. ; Picco, P. ; Martini, G. ; Marazzi, M. G. ; Simonini, G. ; Zulian, F. / Kawasaki's disease in northern Italy : A multicenter retrospective study of 250 patients. In: Clinical and Experimental Rheumatology. 2002 ; Vol. 20, No. 3. pp. 421-426.
@article{7d51208ce821466c9424f1da7bfa5205,
title = "Kawasaki's disease in northern Italy: A multicenter retrospective study of 250 patients",
abstract = "Objective To evaluate (i) the clinical course and outcome in a cohort of 250 children affected with Kawasaki disease (KD) in northern Italy; (ii) the prevalence of coronary aneurysms and their correlation with treatment; and (iii) the prevalence of incomplete and atypical KD in the series as a whole. Results The male to female ratio was 1.8 to 1 and the median age at diagnosis 37 months. The majority of cases occurred in children under five years, with the youngest patient aged 51 days. Median duration of fever was 8 days; median erythrocyte sedimentation rate (ESR) and C Reactive protein (CRP) values, performed before any treatment, were 77 mm/1st h and 10.4 mg/dl respectively. Median haemoglobin (Hb) levels was 9.2 g/dl and median platelet (PTL) count 408,000/mm3. Out of 250 patients, 209 (83.6{\%}) futfilled all criteria for the diagnosis of KD whilst 41/250 (16.4{\%}) had an incomplete disease and 11/250 (4.4{\%}) had an atypical onset. Fifty-four children (21.6{\%}) were treated with aspirin alone (50-80 mg/kg/day, during the acute phase), while 196/250 (78.4{\%}) were given aspirin (50-80 mg/kg day, during the acute phase and then 3-5 mg/Kg/day) and high-dose intravenous gammaglobulin (IVIG, 400 mg/Kg/day or 2 g/Kg/day). Coronary artery abnormalities, including aneurysms and dilatation, were reported in 7/54 patients (5 males and 2 females) who had not received IVIG and 53/196 patients (27 males and 26 females) who were treated with the IVIG in addition to aspirin. Other clinical manifestations included abdominal pain/diarrhoea (11), arthritis (10), hydrops of the gallbladder (8), disseminated intravascular coagulation (3), and hemiparesis (1). All patients except one infant are still alive. In most of the patients coronary alterations normalised, while in 20 patients they persisted for more than one year; in 12/20 patients they were permanent. Conclusion Pediatricians should be aware of the increasing number of children with atypical and incomplete KD, in order to diagnose and treat the disease even in the absence of all typical manifestations and to prevent coronary complications.",
keywords = "Kawasaki's disease",
author = "Fernanda Falcini and R. Cimaz and Calabri, {G. B.} and P. Picco and G. Martini and Marazzi, {M. G.} and G. Simonini and F. Zulian",
year = "2002",
month = "5",
language = "English",
volume = "20",
pages = "421--426",
journal = "Clinical and Experimental Rheumatology",
issn = "0392-856X",
publisher = "Clinical and Experimental Rheumatology S.A.S.",
number = "3",

}

TY - JOUR

T1 - Kawasaki's disease in northern Italy

T2 - A multicenter retrospective study of 250 patients

AU - Falcini, Fernanda

AU - Cimaz, R.

AU - Calabri, G. B.

AU - Picco, P.

AU - Martini, G.

AU - Marazzi, M. G.

AU - Simonini, G.

AU - Zulian, F.

PY - 2002/5

Y1 - 2002/5

N2 - Objective To evaluate (i) the clinical course and outcome in a cohort of 250 children affected with Kawasaki disease (KD) in northern Italy; (ii) the prevalence of coronary aneurysms and their correlation with treatment; and (iii) the prevalence of incomplete and atypical KD in the series as a whole. Results The male to female ratio was 1.8 to 1 and the median age at diagnosis 37 months. The majority of cases occurred in children under five years, with the youngest patient aged 51 days. Median duration of fever was 8 days; median erythrocyte sedimentation rate (ESR) and C Reactive protein (CRP) values, performed before any treatment, were 77 mm/1st h and 10.4 mg/dl respectively. Median haemoglobin (Hb) levels was 9.2 g/dl and median platelet (PTL) count 408,000/mm3. Out of 250 patients, 209 (83.6%) futfilled all criteria for the diagnosis of KD whilst 41/250 (16.4%) had an incomplete disease and 11/250 (4.4%) had an atypical onset. Fifty-four children (21.6%) were treated with aspirin alone (50-80 mg/kg/day, during the acute phase), while 196/250 (78.4%) were given aspirin (50-80 mg/kg day, during the acute phase and then 3-5 mg/Kg/day) and high-dose intravenous gammaglobulin (IVIG, 400 mg/Kg/day or 2 g/Kg/day). Coronary artery abnormalities, including aneurysms and dilatation, were reported in 7/54 patients (5 males and 2 females) who had not received IVIG and 53/196 patients (27 males and 26 females) who were treated with the IVIG in addition to aspirin. Other clinical manifestations included abdominal pain/diarrhoea (11), arthritis (10), hydrops of the gallbladder (8), disseminated intravascular coagulation (3), and hemiparesis (1). All patients except one infant are still alive. In most of the patients coronary alterations normalised, while in 20 patients they persisted for more than one year; in 12/20 patients they were permanent. Conclusion Pediatricians should be aware of the increasing number of children with atypical and incomplete KD, in order to diagnose and treat the disease even in the absence of all typical manifestations and to prevent coronary complications.

AB - Objective To evaluate (i) the clinical course and outcome in a cohort of 250 children affected with Kawasaki disease (KD) in northern Italy; (ii) the prevalence of coronary aneurysms and their correlation with treatment; and (iii) the prevalence of incomplete and atypical KD in the series as a whole. Results The male to female ratio was 1.8 to 1 and the median age at diagnosis 37 months. The majority of cases occurred in children under five years, with the youngest patient aged 51 days. Median duration of fever was 8 days; median erythrocyte sedimentation rate (ESR) and C Reactive protein (CRP) values, performed before any treatment, were 77 mm/1st h and 10.4 mg/dl respectively. Median haemoglobin (Hb) levels was 9.2 g/dl and median platelet (PTL) count 408,000/mm3. Out of 250 patients, 209 (83.6%) futfilled all criteria for the diagnosis of KD whilst 41/250 (16.4%) had an incomplete disease and 11/250 (4.4%) had an atypical onset. Fifty-four children (21.6%) were treated with aspirin alone (50-80 mg/kg/day, during the acute phase), while 196/250 (78.4%) were given aspirin (50-80 mg/kg day, during the acute phase and then 3-5 mg/Kg/day) and high-dose intravenous gammaglobulin (IVIG, 400 mg/Kg/day or 2 g/Kg/day). Coronary artery abnormalities, including aneurysms and dilatation, were reported in 7/54 patients (5 males and 2 females) who had not received IVIG and 53/196 patients (27 males and 26 females) who were treated with the IVIG in addition to aspirin. Other clinical manifestations included abdominal pain/diarrhoea (11), arthritis (10), hydrops of the gallbladder (8), disseminated intravascular coagulation (3), and hemiparesis (1). All patients except one infant are still alive. In most of the patients coronary alterations normalised, while in 20 patients they persisted for more than one year; in 12/20 patients they were permanent. Conclusion Pediatricians should be aware of the increasing number of children with atypical and incomplete KD, in order to diagnose and treat the disease even in the absence of all typical manifestations and to prevent coronary complications.

KW - Kawasaki's disease

UR - http://www.scopus.com/inward/record.url?scp=0036558835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036558835&partnerID=8YFLogxK

M3 - Article

VL - 20

SP - 421

EP - 426

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

SN - 0392-856X

IS - 3

ER -