Clinical characteristics, treatments, and complications of Kawasaki disease in Peruvian children: a retrospective observational study

Background: Kawasaki disease (KD) is a rare medium-sized vessel vasculitis that is the leading cause of acquired heart disease in children. However, most studies on KD focused on its occurrence in infants aged <6 months. Objectives: To evaluate the clinical characteristics, treatments, and complications of KD in Peruvian children. Design: Retrospective observational study. Methods: We collected data from patients aged <18 years who were diagnosed with KD and hospitalized at four healthcare institutions in Lima, Peru, between 2010 and 2022. Clinical characteristics, treatments, and complications were described overall and by age (groups A: <6 months, B: 6 to <12 months, C: 1 to <5 years, and D: ⩾5 years). Results: The median age was 2.3 years (interquartile range: 1.4-4, range: 1 month-13.2 years), and 68% were male. Group A had fewer oral mucocutaneous symptoms, whereas groups C and D had higher frequencies of cervical lymphadenopathy than the other groups. Gastrointestinal symptoms and incomplete KD presentation were common in groups A and D. Elevated white blood cell counts, platelet counts, erythrocyte sedimentation rates, and C-reactive protein levels were observed, particularly in patients with an illness duration of >10 days. A second dose of immunoglobulin was administered to 32 patients, and corticosteroids were administered to 48 patients (21.3%). Immunoglobulin resistance occurred in 14.8% of the patients, predominantly in group D. Coronary aneurysms were observed in 25 patients (12.1%), predominantly in group A. Two patients required intensive care unit admission, and no deaths occurred during hospitalization. Conclusion: Mucocutaneous manifestations of KD in Peruvian children are consistent with those reported in other populations. The frequency of aneurysms and immunoglobulin resistance differed according to age. We emphasize the importance of understanding the clinical presentation of KD, both overall and stratified by age, to prevent late diagnosis and ensure timely treatment.