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a Department of Public
Health, Jichi Medical School, Tochigi, Japan, b Japan Kawasaki
Disease Research Centre, Tokyo, c Department
of Paediatrics and Child Health, Kurume University School of Medicine,
Kurume, Japan
Correspondence to: and reprint requests to: Dr Yosikazu Nakamura, Department of Public Health, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Tochigi 329-0498, Japan.
Accepted 26 September 1997
OBJECTIVE
This study was undertaken to clarify
whether cardiac sequelae due to Kawasaki disease are more frequent
among recurrent cases than initial onset cases.
STUDY DESIGNA cross sectional study using data
from nationwide surveys of Kawasaki disease in Japan was conducted. A
total of 33 976 patients reported were divided into two groups:
initial onset cases (32 923 patients) and recurrent cases (1053 patients). Proportions of cardiac sequelae such as coronary
aneurysms/dilatation, coronary stenosis/narrowing, myocardial
infarction, and valvular lesions were compared between the two groups.
RESULTSThe proportions of patients with the
sequelae were significantly more common among recurrent cases. In men
25.5% of the recurrent cases had the sequelae in comparison with
14.9% for initial onset cases, and in women 16.1% of recurrent cases
had the sequelae compared with 9.8% of initial onset cases. Giant
coronary aneurysms were twice as likely in men in whom the disease was
recurring than in initial onset cases, and 1.5 times more likely in
women in whom the disease was recurring than in initial onset cases.
CONCLUSIONCardiac sequelae of Kawasaki disease
are more likely to appear on recurrent case patients.
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