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CMAJ • March 21, 2000; 162 (6)
© 2000 Canadian Medical Association or its licensors

Review
Synthèse

Recognition and management of Kawasaki disease

Ra K. Han*, Brian Sinclair{ddagger}, Alice Newman*, Earl D. Silverman{dagger}, Gregory W. Taylor§, Peter Walsh§ and Brian W. McCrindle*

From the Divisions of *Cardiology and {dagger}Rheumatology, Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ont.; {ddagger}the Division of Cardiology, Department of Pediatrics, University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, Ont.; and §the Bureau of Cardio-Respiratory Diseases and Diabetes, Laboratory Centres for Disease Control, Health Canada, Ottawa, Ont.

Abstract

Kawasaki disease is the leading cause of acquired heart disease in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. The mean annual incidence of Kawasaki disease across Canada is about 13 per 100 000 children less than 5 years of age, based on hospital discharge data from 1990 to 1995. The cause remains unknown, and the diagnosis is based on the same clinical criteria used to describe the disease over 30 years ago. However, nonspecific clinical features, evolving presentations and atypical or incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment, which occur more frequently in older children, are associated with an increased risk of coronary artery aneurysms. Hence, high diagnostic suspicion and prompt referral are required to reduce the rate of cardiac complications.




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