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Clinical profile of Kawasaki disease in children admitted at a tertiary care hospital of North India and their short-term follow-up


1 Department of Pediatrics, GB Panth Hospital, GMC Srinagar, Srinagar, Jammu and Kashmir, India
2 Department of Pediatrics, GB Panth Hospital, GMC Srinagar, Srinagar, Jammu and Kashmir; Department of pediatric cardiology, Fortis Escorts Heart Institute, New Delhi, India
3 Department of pediatric cardiology, Fortis Escorts Heart Institute, New Delhi, India

Correspondence Address:
Dr. Nargis Banoo
GB Panth Hospital, Sonawar, Srinagar - 190 001, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_201_20

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Year : 2021  |  Volume : 14  |  Issue : 4  |  Page : 459-464

 

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Aim : The aim of this study was to evaluate presenting symptoms, clinical features, and laboratory tests for the diagnosis of Kawasaki disease (KD) in children and their short-term follow-up at a tertiary care hospital of North India from April 2017 to March 2020. Materials and Methods : A total of 31 children (23 boys and 8 girls) up to 10 years of age were included in this study. The diagnosis of KD was made as per the American Heart Association 2017 guidelines. Clinical features, laboratory parameters, and coronary involvement were compared between the complete and incomplete KD groups. Results : The incidence of complete versus incomplete KD was 19 (61.2%) versus 12 (38.7%) children, respectively. Change in extremities and oral mucosal changes were more encountered in the complete KD group as compared to the incomplete KD group (100% vs. 58.3%, P = 0.004, and 78.9% vs. 33.3%, P = 0.002, respectively). Coronary artery aneurysm was seen in 54% of the patients on echocardiography which was greater in the incomplete KD group (83.3%) as compared to the complete KD group (36.8%). The median time from the onset of symptoms to intravenous immunoglobulin infusion was <10 days in 84.2% of the patients with complete KD versus 41.7% with incomplete KD which was statistically significant. Fifty percent of the children with coronary ectasia and small aneurysm had normal coronaries at follow-up of 6 months. Conclusion : KD is probably underdiagnosed in most developing countries, like that of ours, and requires a high index of suspicion.






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1 Department of Pediatrics, GB Panth Hospital, GMC Srinagar, Srinagar, Jammu and Kashmir, India
2 Department of Pediatrics, GB Panth Hospital, GMC Srinagar, Srinagar, Jammu and Kashmir; Department of pediatric cardiology, Fortis Escorts Heart Institute, New Delhi, India
3 Department of pediatric cardiology, Fortis Escorts Heart Institute, New Delhi, India

Correspondence Address:
Dr. Nargis Banoo
GB Panth Hospital, Sonawar, Srinagar - 190 001, Jammu and Kashmir
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.APC_201_20

Rights and Permissions

Aim : The aim of this study was to evaluate presenting symptoms, clinical features, and laboratory tests for the diagnosis of Kawasaki disease (KD) in children and their short-term follow-up at a tertiary care hospital of North India from April 2017 to March 2020. Materials and Methods : A total of 31 children (23 boys and 8 girls) up to 10 years of age were included in this study. The diagnosis of KD was made as per the American Heart Association 2017 guidelines. Clinical features, laboratory parameters, and coronary involvement were compared between the complete and incomplete KD groups. Results : The incidence of complete versus incomplete KD was 19 (61.2%) versus 12 (38.7%) children, respectively. Change in extremities and oral mucosal changes were more encountered in the complete KD group as compared to the incomplete KD group (100% vs. 58.3%, P = 0.004, and 78.9% vs. 33.3%, P = 0.002, respectively). Coronary artery aneurysm was seen in 54% of the patients on echocardiography which was greater in the incomplete KD group (83.3%) as compared to the complete KD group (36.8%). The median time from the onset of symptoms to intravenous immunoglobulin infusion was <10 days in 84.2% of the patients with complete KD versus 41.7% with incomplete KD which was statistically significant. Fifty percent of the children with coronary ectasia and small aneurysm had normal coronaries at follow-up of 6 months. Conclusion : KD is probably underdiagnosed in most developing countries, like that of ours, and requires a high index of suspicion.






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