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Kawasaki disease: clinical spectrum of 88 patients in a high-prevalence African-American population.
J Natl Med Assoc. 2008 Jan;100(1):28-32.
Marquez J, Gedalia O, Candia L, Ranjit K, Hescock GC, Espinoza LR, Stopa AR, Gedalia A.
Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital, New Orleans, LA 70118, USA.
Kawasaki
disease (KD) is a systemic vasculitis that predominantly affects
infants and young children. Asian race has been described as an
important factor for the development of this disease. We reported our
experience in a cohort of patients with KD. Clinical and laboratory
data from initial presentation and follow-up visits were reviewed in 88
patients with KD treated at Children's Hospital of New Orleans between
March 1993 and November 2004. Forty-nine (56%) patients were African
American, 35 (40%) Caucasian, two (3%) Asian and two (3%) Hispanic.
Coronary artery aneurysms (CAAs) were detected in 15 (17%) patients.
CAAs were less frequent in African-American patients compared to
Caucasians [relative risk (RR)=0.2, 95% CI: 0.04400-0.8405, p=0.0164].
Eighty-three patients responded to one dose of intravenous human
immunoglobulin (IVIG), five patients responded to a second infusion of
IVIG, and two who were IVIG resistant responded only following
methylprednisolone pulse. Hemoglobin (Hb) levels of <10 g/dl and
presence of polymorphic rash were significantly correlated with
development of CAAs. No deaths were observed.
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