317 Cardiac features of Kawasaki Disease in France: a single-center esperience

Little is known about Kawasaki Disease (KD) features in France. The aims of this retrospective single-center study were to assess the characteristics of a French KD population over a long period of time, and to describe cardiac lesions.MethodsWe retrospectively reviewed the medical records of 417 patients referred to echocardiography for KD suspicion between August 1983 and April 2007.Results210 patients met criteria for diagnosis of KD, at the age of 2.7±2.5years (median 2). Fever was present in all patients. Time to diagnosis was 7±4.6days (median 6days), time to hospitalization 5.7±4.3days (median 5days). Time to first echocardiography was 11.4±7.8days (median 9days), shorter in more recent period. Median time to IVIG administration was 8 days (1 to 39). At initial evaluation, 63.8% were free from cardiac lesions, 23.8% (52 cases) had coronary lesions (aneurisms : 25, dilatation : 27) and 12.4% had « hyperechogen » coronary arteries. Among 52 cases with abnormal coronary arteries, 40 were <5mm in diameter, 9 were 5-8mm, and 3 were >8mm (giant aneurisms): one third localized on one coronary vessel, one third on 2 and one third one all 3 coronary arteries. Echographic pericarditis was found in 31 patients, mitral insufficiency in 20 and aortic insufficiency in 2. All patients recovered, except 1 who died from cardiogenic shock due to ruptured chordae. Coronary lesions resolved in 17 of 52 cases (32.6%) and persisted in 35 (67.4%, i.e. 16.7% of all patients): 14 with aneurisms and 19 with dilatations. No patient developped significant long-term coronary artery stenosis. The incidence of aneurisms was lower over the past decade (7.2%).ConclusionIn our experience, the occurrence of coronary lesions in KD have lessened over time and long-term cardiac outcome is favourable despite persistent coronary lesions