maria emília pereira baião silva aspectos epidemiológicos, clínicos ...

ABSTRACT
Background: Kawasaki Disease is an acute, self-limited systemic vasculitis of unknown
etiology. The diagnosis is established clinically considering symptoms of fever lasting at least
5 days together with 4 of the following: conjunctivitis, oral changes, changes in the
extremities, exanthem and cervical adenopathy.
Objectives: To identify and to analyze the epidemic, clinical and therapeutic aspects of the
disease in patients hospitalized at the Hospital Infantil Joana de Gusmao, Florianopolis, Santa
Catarina, between 1980 and 2005.
Method: An analysis of each diagnosed patient was carried out using medical records and
interviews with parents of the patients and considering age; age group; sex; colour/race;
residence; year and seasonal occurrence; clinical findings and diagnostic criteria;
complementary exams; heart involvement; use of immunoglobulin and other medications;
complications; duration of hospitalization; death; complications after the discharge and
outpatient evolution.
Results: Twenty three cases occurred in the period, with increasing frequency of occurrence
from 2001. The predominance of children were less than 5 years old (56.5% less than 2 years
old) and were boys, of white colour/race, and residents of Florianopolis. The results indicate a
greater occurrence in the winter and spring months. Of the patients, 65.2% filled the
diagnostic criteria. Anemia, leukocytosis with neutrophily, thrombocytosis, increase of
erythrocyte sedimentation rate and of C-reactive protein were frequent findings. Heart
involvement occurred in 60.9% with prevailing coronary abnormalities. Intravenous
immunoglobulin was used in 95.7% of the children, with a mean of 10.6 days of illness, and
acetilsalycilic acid in 100% of them. The mean duration of hospitalization was 8.7 days.
Complications occurred in 8.7% of the cases, without deaths.
Conclusion: The diagnosis was found to be late, in spite of the appropriate treatment being
given. Heart involvement was common, specially of the coronary arteries.
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