Clinical and Epidemiological Characteristics of Kawasaki Disease With Special Reference to Cardiac Involvement

Abstract

BACKGROUND Kawasaki disease (KD) is an acute medium vessel vasculitis with multisystem involvement especially in young children of unknown etiology and present as acute febrile illness. It is the leading cause of acquired heart disease in children across the globe. OBJECTIVES We aimed to evaluate the epidemiological characteristics, clinical manifestations and cardiac involvement of KD in children residing in Tripura, a North Eastern State of India. MATERIALS AND METHODS In this retrospective study, we reviewed the medical records of all children with KD who had been admitted in Pediatric ward of Tripura Medical College & DR BRAM Teaching Hospital, Agartala from March 2007 to February 2015. Data regarding clinical, epidemiological characteristics, Cardiac involvement, laboratory parameter, management, and the outcome of disease for each patient were obtained. The patients were divided into cardiac and non-cardiac groups based on echocardiographic results. RESULTS In total, 30 patients with KD (18boys and 12 girls) were enrolled in this study. The male to female ratio was 1.5:1. The median age at diagnosis was 15 months, and the diagnosis was made after a mean of 8.1 days of fever. A seasonal peak during the winter-spring months was observed. 23 (76.6%) had classical presentation of KD. Fever, polymorphs, skin rash, conjunctivitis, changes in the oropharynx were the most common manifestations. Cardiac involvement was detected in 7(23.3%)%, with coronary artery abnormalities (CAA) and 26(86.5%) patient showed ECG abnormality. Patients were treated with immunoglobulin and aspirin. The CAA regressed in all patients but one persisted even after 12 months. CONCLUSION Kawasaki disease is not rare in Tripura. The age, gender distribution and clinical findings are similar to that of other reports. Patients with cardiac abnormalities had delayed treatment and prolonged hospital stays.