Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience

<b>Background:</b> Kawasaki disease (KD) is an acute inflammatory vasculitis with a particularly high incidence of coronary artery complications and constitutes a significant cause of acquired heart disease in children and young adults. <b>Methods:</b> We conducted a retrospe...

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Main Authors: Cristina Ramona Rădulescu, Anca Cristina Drăgănescu, Diana Maria Băncilă, Anuţa Bilaşco, Mihai-Rareş Bădescu, Doina Anca Pleşca
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/656
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author Cristina Ramona Rădulescu
Anca Cristina Drăgănescu
Diana Maria Băncilă
Anuţa Bilaşco
Mihai-Rareş Bădescu
Doina Anca Pleşca
author_facet Cristina Ramona Rădulescu
Anca Cristina Drăgănescu
Diana Maria Băncilă
Anuţa Bilaşco
Mihai-Rareş Bădescu
Doina Anca Pleşca
author_sort Cristina Ramona Rădulescu
collection DOAJ
description <b>Background:</b> Kawasaki disease (KD) is an acute inflammatory vasculitis with a particularly high incidence of coronary artery complications and constitutes a significant cause of acquired heart disease in children and young adults. <b>Methods:</b> We conducted a retrospective analysis of consecutive patients aged 0–18 years hospitalized at the “Prof. Dr. Matei Balş” National Institute of Infectious Diseases in Bucharest with Kawasaki disease over a period of 6 years (2018–2023). <b>Results:</b> A total of 25 children were discharged from hospital with this diagnosis during the analyzed period. The mean age was 2.9 years, and 56% were boys. Fever ≥5 days was present in all cases, and the most frequent additional sign was the presence of oral changes. Patients were treated according to in-effect guidelines with intravenous immunoglobulin (IVIG) (100%) and acetylsalicylic acid (68%). Only two cases were considered IVIG resistant and received a second IVIG infusion. Only mild cardiovascular changes were noted in echocardiography: mild coronary artery dilatation (21.7% of cases), mild valvular regurgitation, and small pericardial effusion. Infants displayed less inflammation and higher percentages of leukocytosis, developed an increase in platelet count sooner, received IVIG faster, and had longer hospital stays. Outcomes were generally favorable, and 92% of children were discharged, while the two remaining patients were transferred to other centers. No deaths were recorded. <b>Conclusions:</b> To our knowledge, this is the largest contemporary Romanian cohort of Kawasaki disease published to date, outlining the local diagnostic process, therapeutic strategies, and early outcomes of Kawasaki disease.
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spelling doaj-art-a777bd221f184c088fe17bd400cff89e2025-08-20T02:11:18ZengMDPI AGDiagnostics2075-44182025-03-0115665610.3390/diagnostics15060656Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center ExperienceCristina Ramona Rădulescu0Anca Cristina Drăgănescu1Diana Maria Băncilă2Anuţa Bilaşco3Mihai-Rareş Bădescu4Doina Anca Pleşca5Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Prof. Dr. Matei Balş” National Institute of Infectious Diseases, 021105 Bucharest, RomaniaDepartment of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania<b>Background:</b> Kawasaki disease (KD) is an acute inflammatory vasculitis with a particularly high incidence of coronary artery complications and constitutes a significant cause of acquired heart disease in children and young adults. <b>Methods:</b> We conducted a retrospective analysis of consecutive patients aged 0–18 years hospitalized at the “Prof. Dr. Matei Balş” National Institute of Infectious Diseases in Bucharest with Kawasaki disease over a period of 6 years (2018–2023). <b>Results:</b> A total of 25 children were discharged from hospital with this diagnosis during the analyzed period. The mean age was 2.9 years, and 56% were boys. Fever ≥5 days was present in all cases, and the most frequent additional sign was the presence of oral changes. Patients were treated according to in-effect guidelines with intravenous immunoglobulin (IVIG) (100%) and acetylsalicylic acid (68%). Only two cases were considered IVIG resistant and received a second IVIG infusion. Only mild cardiovascular changes were noted in echocardiography: mild coronary artery dilatation (21.7% of cases), mild valvular regurgitation, and small pericardial effusion. Infants displayed less inflammation and higher percentages of leukocytosis, developed an increase in platelet count sooner, received IVIG faster, and had longer hospital stays. Outcomes were generally favorable, and 92% of children were discharged, while the two remaining patients were transferred to other centers. No deaths were recorded. <b>Conclusions:</b> To our knowledge, this is the largest contemporary Romanian cohort of Kawasaki disease published to date, outlining the local diagnostic process, therapeutic strategies, and early outcomes of Kawasaki disease.https://www.mdpi.com/2075-4418/15/6/656Kawasakiprolonged feverIVIGaspirinechocardiographycoronary artery lesions
spellingShingle Cristina Ramona Rădulescu
Anca Cristina Drăgănescu
Diana Maria Băncilă
Anuţa Bilaşco
Mihai-Rareş Bădescu
Doina Anca Pleşca
Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
Diagnostics
Kawasaki
prolonged fever
IVIG
aspirin
echocardiography
coronary artery lesions
title Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
title_full Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
title_fullStr Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
title_full_unstemmed Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
title_short Contemporary Diagnosis, Management, and Early Outcomes in Children with Kawasaki Disease in Romania: A Single-Center Experience
title_sort contemporary diagnosis management and early outcomes in children with kawasaki disease in romania a single center experience
topic Kawasaki
prolonged fever
IVIG
aspirin
echocardiography
coronary artery lesions
url https://www.mdpi.com/2075-4418/15/6/656
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