Cardiac sequelae of Kawasaki disease among recurrent cases.

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 DESIGN A 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. RESULTS The 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. CONCLUSION Cardiac sequelae of Kawasaki disease are more likely to appear on recurrent case patients.