An Epidemiologic Study of Kawasaki Disease(1987-2000): Incidence of Coronary Artery Complication in the Acute Stage

Lee, Kyung Yil; Park, Min Young; Han, Ji Whan; Lee, Hyung Shin; Choi, Jin; Whang, Kyung Tai

Abstract

PURPOSE: We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment.
METHODS
We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000.
RESULTS
The mean annual incidence was 36.1+/-11.1 cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was 2.4+1.7 years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated(400-500 mg/dayX4-5 days, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case.
CONCLUSION
In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.