2017 年 87 巻 Extra1 号 p. E65-E72
Introduction: We examined patients with Kawasaki disease who were treated at our hospital. Here, we discuss our experience and current issues.
Methods: All patients who were treated for the acute phase of Kawasaki disease at our hospital between 1999 and 2016 were enrolled. Based on their medical records, epidemiological matters and treatment methods were retrospectively evaluated.
Results: A total of 776 patients with Kawasaki disease were treated at our hospital. The male-to-female ratio was 1.6. The majority of patients were 1 year old. Forty-eight cases exhibited coronary artery abnormalities (6.2 %). Eleven cases exhibited transient coronary artery dilatation during the acute phase, whereas eight had a moderate-sized to large-sized coronary aneurysm as a sequela. Overall, 15.7 % (101/643) of the patients did not respond to the initial IVIG therapy, and the incidence of coronary sequela among the non-responders was 21.8 % (22/101). The incidences of coronary artery abnormalities among patients with complete and incomplete Kawasaki disease were 5.1 % and 5.8 %, respectively.
Conclusion: We concluded that two major problems currently exist in the treatment of Kawasaki disease. The first problem is the management of cases that are refractory to initial IVIG therapy, and the second problem is the diagnosis and treatment of patients with incomplete Kawasaki disease. The development of treatment options for refractory cases is urgently needed.
