Kawasaki disease in Ukraine

Abstract

Introduction. Kawasaki disease (KD) is an acute systemic vasculitis and the leading cause of acquired heart disease in children in developed countries. Although well-characterized internationally, KD has historically been underrecognized in Ukraine. Since 2016, continuous monitoring of KD cases has been conducted at Kyiv Children’s Hospital №1 (KCH1), forming the basis for the first Ukrainian epidemiological data. In 2018, the initial national incidence was reported at 4.6 per 100,000 children under five years of age. This study presents updated data from KCH1 for 2024, reflecting both clinical and epidemiological trends. Data from Kyiv can be reasonably extrapolated to the Ukrainian population. Materials and methods. A retrospective analysis was performed on 14 pediatric patients diagnosed with KD and hospitalized at KCH1 in 2024. Data included demographic parameters, clinical presentation, treatment, echocardiographic evaluation, and follow-up. Coronary artery lesions (CALs) were assessed using Z-scores. Diagnosis was based on the AHA 2017 criteria for complete and incomplete KD. Intravenous immunoglobulin (IVIG) was administered in standard dosing (2 g/kg), unless otherwise indicated. Results. We present the clinical profile of children with KD treated at KCH1 in 2024. The median age was 39 months (range: 1–93 months), with equal sex distribution (7 males, 7 females). All patients received IVIG; one required a second dose due to resistance, and one had a self-limited course without IVIG. The average hospitalization duration was 7 days. Severe disease manifestations were more common in infants. Atypical forms mimicked other conditions, including urinary tract infection, acute abdomen, retropharyngeal phlegmon, and infective endocarditis. CALs were documented in 50% of patients (7/14), including coronary dilations and small-to-medium aneurysms; no giant aneurysms were observed. Follow-up at six months showed resolution of CALs in three patients. The clinical manifestations observed in 2024 were consistent with those recorded in previous years. Conclusions. The estimated KD incidence in Kyiv in 2024 was 10–15 per 100,000 children under five years—over twice the rate reported in 2018. The clinical spectrum and frequency of CALs remain similar to European countries that report national data. Given these findings, data from Kyiv can be reasonably extrapolated to the Ukrainian population. Further surveillance of KD in Ukraine is essential to ensure early recognition and improved long-term outcomes.