Recognition and management of Kawasaki disease

KAWASAKI DISEASE:IS THE LEADING CAUSE of acquired heart disease in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. The mean annual incidence of Kawasaki disease acros s Canada is about 13 per 100 000 children less than 5 years of age, based o n hospital discharge data from 1990 to 1995. The cause remains unknown, and the diagnosis is based on the same clinical criteria used to describe the disease over 30 years ago. However, nonspecific clinical features, evolving presentations and atypical or incomplete presentations make early diagnosi s and timely treatment difficult. Delays in diagnosis and treatment, which occur more frequently in older children, are associated with an increased r isk of coronary artery aneurysms. Hence, high diagnostic suspicion and prom pt referral are required to reduce the rate of cardiac complications.