Profile of Kawasaki disease at a tertiary care center in India
Sagar Bhattad1, Sandip Gupta2, Neha Israni3, Sweta Mohanty4
1 Department of Pediatrics, Division of Pediatric Rheumatology and Immunology, Aster CMI Hospital, Bengaluru, Karnataka, India
2 Department of Pediatrics, Division of Pediatric Intensive Care, Aster CMI Hospital, Bengaluru, Karnataka, India
3 Department of Pediatrics, Aster CMI Hospital, Bengaluru, Karnataka, India
4 Department of Cardiac Sciences, Division of Pediatric Cardiology, Aster CMI Hospital, Bengaluru, Karnataka, India
Department of Cardiac Sciences institution, Division of Pediatric Cardiology, Aster CMI Hospital, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Background : Kawasaki disease (KD) is the most common cause of acquired heart disease in developed countries. KD is increasingly being reported from India; however, studies involving the large number of patients are few.
Methods : All children presenting to the center from January 2017 to December 2019, diagnosed to have KD, were retrospectively included in the study. Clinical and laboratory profiles, including echocardiograms, were reviewed. Factors contributing to intravenous immunoglobulin (IVIg) refractoriness and the development of coronary artery abnormalities (CAA) were assessed.
Results : A total of 39 children with KD presented to the center during the study. While 32 received initial treatment at our center, seven were referred after the initial IVIg infusion. The age range was 2 months to 11 years (mean 42.15 ± 38.51 months). More than two-thirds of the cohort was male (n = 27/39). Mucosal involvement was the commonest clinical abnormality for the group, followed by rash. Hemoglobin was significantly lower in the group with coronary artery involvement (P = 0.001). CAA (61.5%), incomplete KD, and atypical features were much more common in infants compared to the rest. Refractoriness to treatment was significantly more common in infants (P = 0.029).
Conclusions : A significant proportion of infants with KD had cardiac involvement. Infants were more likely to have IVIg-resistant disease.