Background: The aim of this study was to estimate the incidence and describe the epidemiological characteristics of Kawasaki disease among children in Korea. Methods: Questionnaires for surveying the epidemiology of Kawasaki disease were distributed to a total of 101 hospitals that conduct pediatric residency programs. Then, we retrospectively obtained the data, which covered a three-year period (2006)(2007)(2008) The seasonal distribution showed a slightly higher incidence rate in winter and summer. The patients' mean age of onset was 32.6 months, while the proportions of sibling cases and recurrent cases were 0.17% and 2.2%, respectively. Coronary arterial abnormalities were detected during follow up by echocardiogram in 17.5% of all cases including dilatations (16.4%) and aneurysms (2.1%). Conclusions:The average annual incidence rate of Kawasaki disease in Korea has been continuously increasing, and reached 113.1/100 000 children <5 years old, which is the second highest rate in the world.

The average annual incidence, 86.4/100 000 in children <5 years old is the second highest rate in the world.

We performed a retrospective epidemiologic survey on Kawasaki disease (KD) from 1997 to 1999 in Korea. We sent a questionnaire to 111 training hospitals, and summarized the data from 50 hospitals that responded. Data from a total of 3,862 cases were collected, which showed no difference in annual incidence and a seasonal predilection for summer. The male-to-female ratio was 1.51:1, and the mean age was 29.7 months. The prevalence of sibling cases was 0.26%, and the rate of recurrent cases was 2.3%. The proportion of patients with KD among total hospitalized pediatric patients was 1.19% in average, showing a significant difference according to the regions. Coronary arterial (CA) abnormalities were detected by echocardiography in 19.8% of cases (737/3,723) including dilatations in 601 cases (16.1%) and aneurysms in 191 cases (5.1%). Data from total 8,251 cases in the 1990s including the cases in the present study, in Korea showed a mean age of patients 28.9 months, male-to-female ratio 1.6:1, seasonal predilection for summer, prevalence of sibling cases 0.24%, rate of recurrent cases 2.3%, incidence of CA abnormalities 21.0%, and incidence of CA aneurysms 5.2%, with statistically significant decreasing trends in the male-to-female ratio and the rate of CA abnormalities.

Background and Objectives: The goal of this study was to assess changes in left ventricular (LV) function and to identify pre-closure factors associated with LV dysfunction {fractional shortening (FS) below 29%} after transcatheter patent ductus arteriosus (PDA) closure. Subjects and Methods: Forty-three pediatric patients with PDAs underwent cardiac catheterization for hemodynamic studies and intervention. Doppler echocardiography was performed at pre-closure, post-closure, and follow-up. Results: S' and A' of the septum and mitral annulus were significantly decreased at post-closure and follow-up, respectively. In five of eight patients with Qp/Qs ratios over 1.60 and Pp/Ps ratios over 0.32 at pre-closure, the FS was decreased below 29% at post-closure. Qp/Qs ratio over 1.60 and Pp/Ps ratio over 0.32 at pre-closure had a sensitivity of 86% and a specificity of 84% for predicting FS to be below 29% at post-closure. Conclusion: Larger amounts of pre-closure left-to-right shunting and higher pulmonary artery pressure were associated with an increased likelihood of FS <29% after closure. The results of this study suggest that serial assessments of ventricular function are needed after PDA occlusion in patients with high Qp/Qs and Pp/Ps ratios.

Background and ObjectivesThis was a multicenter study to evaluate the usefulness of the tumor necrosis factor-alpha (TNF-α) blocker infliximab for treatment of Korean pediatric patients with refractory Kawasaki disease (KD).Subjects and MethodsData from 16 patients throughout Korea who were diagnosed with refractory KD and received infliximab were collected retrospectively.ResultsComplete response to therapy with cessation of fever occurred in 13 of 16 patients. C-reactive protein (CRP) concentrations decreased following infliximab infusion in all 14 patients in whom it was measured before and after treatment. There were no infusion reactions or complications associated with infliximab except in 1 case with acute hepatitis occurring during treatment followed by calculous cholecystitis 4 months later. Fifteen patients had coronary artery (CA) abnormalities before infliximab therapy. Three had transient mild dilatation and 9 had CA aneurysms, with subsequent normalization in 4 patients, persistent mild dilatation in 3, persistent aneurysm in 2, and there were 3 cases (2 with CA aneurysm, 1 with mild CA dilatation) without follow-up echocardiography.ConclusionThe results of this study suggest that infliximab may be useful in the treatment of refractory KD, and it appears that there is no significant further progression of CA lesions developing after infliximab treatment. Multicenter trials with larger numbers of patients and long-term follow-up are necessary to assess the clinical efficacy and safety of infliximab in refractory KD.