Cardiac sequelae in recurrent cases of Kawasaki disease: A comparison between the initial episode of the disease and a recurrence in the same patients

Objective. Cardiac sequelae develop more frequently after recurrent Kawasak i disease than from the initial onset of the disease. The purpose of this s tudy was to observe the existence of the sequelae at the initial and second onsets of the disease simultaneously with a large cohort. Materials and Methods. From the database of patients with Kawasaki disease prepared by the Japanese Kawasaki Disease Research Committee, 559 cases wit h recurrences recorded between 1989 through 1994 and their initial occurren ce listed in the database were selected. Their proportions of cardiac seque lae after the initial and second onsets of Kawasaki disease were compared. Results. Of the 68 patients with cardiac sequelae after the initial onset, 32 (47%) suffered the sequelae after the second onset, whereas 78 (16%) of the 491 who were without cardiac sequelae after the initial onset developed the sequelae after the recurrence. Both proportions were higher than propo rtions in all patients with Kawasaki disease. In addition to the sex (male) and the existence of the sequelae after the initial onset, age art the sec ond onset (older age) and the interval between the two episodes (longer per iod) were suspected to be risk factors for sequelae attributable to recurre nt Kawasaki disease. Conclusion. Linked data of the initial and second episodes of Kawasaki dise ase showed that the risk of developing cardiac sequelae attributable to rec urrent Kawasaki disease is high among both those with and without the seque lae at the initial episode.