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Profile of Kawasaki disease at a Tertiary Care centre in South India

Sandip Gupta

Statement of the Problem: Kawasaki disease (KD) is the most common cause of acquired heart disease in developed countries. KD is increasingly being reported from India, however, there is paucity of data from Indian subcontinent.

Methodology: 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 profile including echocardiograms were reviewed. Factors contributing to intravenous immunoglobulin (IVIg) refractoriness and development of coronary artery abnormalities were assessed.

Results: A total of 39 children with KD presented to the center during the study period. While 32 received initial treatment at our center, seven were referred after the initial intravenous immunoglobulin (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). Incomplete KD, atypical features and coronary artery abnormalities (61.5%) were much more common in infants compared to the rest (34.6%). Refractoriness to treatment was significantly more common in infants (p=0.029).

Conclusion: A significant proportion of infants with KD had cardiac involvement. Infants were more likely to have IVIg-resistant disease.