Incidence and course of Kawasaki disease in Mexico

Introduction: Kawasaki disease (KD) affects children aged 1 to 5 years. It manifests with fever and vasculitis in various organs and damage to the coronary arteries in the heart occur. Objective: To analyze KD after reviewing what was published in Mexico from 1977 to 2010. Material and methods: Based on the published material on KD, diagnostic clinical findings, cardiac disorders, laboratory analyses and imaging, complications, treatment disease course and mortality, as well as descriptive statistics were used. Results: In 155 cases, patient ages ranged from 3 to 5 years, the proportion of males vs females was 3.3:1; coronary aneurysms were found by echocardiography in 61 children (39%), myocarditis in 19 (12%), pericardial effusion in 9 (5.8%), aortic insufficiency in 4, mitral regurgitation in 5, the most common laboratory findings were leucocytosis, neutrophilia, thrombocytosis, elevation of ESR and C-reactive protein level. Forty-two patients were treated with aspirin, 104 (67%) received gamma globulin and aspirin, 30 (19%) dipyridamole, and prednisone and methylprednisolone were used in less than 3% of the patients. Three months after their discharge from hospital, 124 children (80%) had no sequelae, 11 had giant aneurysms, and 8 myocardial infarction, 3 had bypass surgery, 3 died (1.9%). Conclusions: In Mexico, the early use of gamma globulin and aspirin resulted in a decrease of coronary lesions due to Kawasaki disease.