Clinical profile of patients with Kawasaki disease from a tertiary care hospital of western region of Assam

Abstract

Kawasaki disease (KD) is a common vasculitic disease occurring predominantly in children. Early diagnosis of this condition is very important because if untreated or not instituted the treatment with intravenous immunoglobulin (IVIg) before 10 days of illness, 25% of children can develop coronary artery aneurysm. After timely treatment this figure comes down to 3-4%. KD is reported from all regions of the world and from almost all states of India. Annual incidence is highest in Japan followed by Korea and Taiwan. There is paucity of reports on KD from Assam. In this study we report our experience of managing 11 children with KD at our centre. In this study five patients with KD were complete KD and six patients were incomplete KD. There were several unusual findings in our study like presentation with acute arthritis and fever in one patient, gastrointestinal complaints (e.g., diarrhea, vomiting and pain abdomen) in four patients, hydrops of gallbladder in one patient, BCG inoculation site reactivation in one patient and pericardial effusion in one patient. Cardiovascular complications like left ventricular dysfunction was observed during acute phase in one patient and mild dilatation of left main coronary artery was observed in one patient. Nine out of 11 patients had responded promptly to IVIg infusion at the dose of 2 g/kg over 12-15 hours. Two children were resistant to IVIg and one of these patients had developed polyserositis after four days post-IVIg. However, parents refused further treatment of these children. There was no death in our cohort and nine patients who responded well to IVIg had completed a median of 0.3 year (Range, 0.1 -1 year) follow-up.