Objective: To analyze the epidemiology of Kawasaki disease in Icelandic children and its complications.

Methods: A retrospective analysis of all cases of Kawasaki disease and atypical Kawasaki disease in children in Iceland from 1996-2005. Chart records were reviewed and children diagnosed at Landspítali – University Hospital invited for a Follow up study with emphasis on heart complications.

Results: Thirty children were diagnosed with Kawasaki disease, annual incidence was 10.7/100.000 children <5 years of age. The boy:girl ratio was 2.3:1. All 30 children were treated with IVIG, without any major adverse events related to the treatment. The median time from the initial symptoms to treatment was six days (range 3-31 days). There was no mortality. Two children developed coronary aneurysms and three coronary ectasia. Follow up echocardiography was preformed in 23 of the children four to twelve years after Kawasaki disease. Two of the children still had coronary ectasia, and six (26%) had mitral regurgitation.

Conclusions: The incidence of Kawasaki disease in Iceland was comparable to an earlier Icelandic study and reported incidence in the Nordic countries. Coronary involvement during the acute phase was mild, and all coronary aneurysm regressed. Serious cardiac complications were not seen. Children with Kawasaki disease in Iceland have favorable prognosis. Interestingly, mild mitral regurgitation and coronary ectasia were common at mid-term follow up.

Olafsdottir HS¹, Oskarsson G^1,2, Haraldsson A^1,2

¹Faculty of Medicine, University of Iceland, ²Childrens hospital of Hringurinn, Landspitali University Hospital.

Fig. 1. Age distribution of Kawasaki patients in Iceland, 1996-2005.

Fig. 2. Incidence of Kawasaki disease in Iceland in children < 5 years old 1996-2005.

Fig. 3. Number of Kawasaki patients that had each diagnostic criteria.

 

Table I. Diagnostic criteria for Kawasaki Disease.

Table II. Results of echocardiogram.