Clinical & laboratory profiles and treatment outcome of Kawasaki disease in children: Experience from a tertiary care hospital.

BACKGROUND: A total of 40 cases of Kawasaki Disease (KD), diagnosed & categorized on the basis of criteria set by the American Heart Association were studied. We sought to evaluate their clinical and laboratory analysis along with their treatment. METHODS: After inclusion, they underwent thorough clinical and laboratory analysis and were treated with intravenous immunoglobulin and aspirin. Their clinical & laboratory findings and treatment outcome were analyzed further using Epi info and at a probability of (p value) < 0.05, was considered statistically significant. RESULTS: The mean age of the cases was 4.1 ± 2.9 years and boys outnumber the girls (57% vs. 43%). Most (65%) of the cases were incomplete KD compared to 35% as complete KD. The mean duration of fever was 11.7 ± 5.53 days. The frequency of the different classic clinical findings of KD were- cracking of lips & redness of oral cavity (72%), polymorphous skin rash (50%), conjunctival injection (45%), changes in the distal extremities (38%), cervical lymphadenitis (30%) and erythema on BCG scar (7.5%). High C-Reactive protein (CRP > 10 mg/dl), thrombocytosis, anaemia and leukocytosis were 85%, 45%, 43%, 38% respectively. Echocardiography showed coronary artery abnormalities (CAA) dilatation and aneurysm in 82.5% and 12.5% cases respectively which came down to 68% and 10% after receiving treatment with IVIg and Aspirin. CONCLUSION & RECOMMENDATION: Diagnosis of KD is essentially clinical and criteria-based and 95% were complicated with CAA. Timely intervention with IVIG was mostly effective. Therefore, high index of suspicion of a long-continued febrile child is recommended to reach the diagnosis and to initiate timely intervention so as to potentially prevent CAA.