RT Journal Article
SR Electronic
T1 Kawasaki disease: a prospective population survey in the UK and Ireland from 2013 to 2015
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP archdischild-2018-315087
DO 10.1136/archdischild-2018-315087
A1 Robert M R Tulloh
A1 Richard Mayon-White
A1 Anthony Harnden
A1 Athimalaipet V Ramanan
A1 E Jane Tizard
A1 Delane Shingadia
A1 Colin A Michie
A1 Richard M Lynn
A1 Michael Levin
A1 Orla D Franklin
A1 Pippa Craggs
A1 Sue Davidson
A1 Rebecca Stirzaker
A1 Mike Danson
A1 Paul A Brogan
YR 2018
UL http://adc.bmj.com/content/early/2018/08/12/archdischild-2018-315087.abstract
AB Objective Kawasaki disease (KD) is an increasingly common vasculitis with risk of coronary artery aneurysms (CAAs). The last UK survey was in 1990, whereas current epidemiology, treatment patterns and complication rates are unknown. The aim of this study was to address this knowledge gap.Methods A British Paediatric Surveillance Unit survey in the UK and Ireland from 1 January 2013 to 28 February 2015 ascertained demographics, ethnicity, seasonal incidence, treatment and complication rates.Results 553 cases were notified: 389 had complete KD, 46 had atypical KD and 116 had incomplete KD; 2 were diagnosed at postmortem with an incidence of 4.55/100 000 children under 5 years, with a male to female ratio of 1.5:1 and a median age of 2.7 years (2.5 months–15 years). Presentation was highest in January and in rural areas. Most were white (64%), and Chinese and Japanese Asians were over-represented as were black African or African mixed-race children. 94% received intravenous immunoglobulin (IVIG). The overall CAA rate was 19%, and all-cardiac complications affected 28%. Those with CAA received IVIG later than in those without (median 10 days vs 7 days). Those under 1 year had fewer symptoms, but the highest CAA rate (39%). Overall 8 of 512 cases (1.6%) had giant CAA, and 4 of 86 cases (5%) under 1 year of age developed giant CAA. Mortality from KD was 0.36%.Conclusions The UK and Ireland incidence of KD has increased and is more frequently seen in winter and rural areas. Delayed IVIG treatment is associated with CAA, suggesting earlier and adjunctive primary treatment might reduce complications to prevent CAA, particularly in the very young.