Immunoglobulin for Kawasaki disease: a 3-year retrospective audit

Abstract

AimTo evaluate whether intravenous immunoglobulin (IVIG) use in children with suspected Kawasaki disease (KD) was given according to local trust and the newly revised American Heart Association (AHA) guidelines.MethodsIn our tertiary hospital, any child with suspected KD given IVIG, over the past 3 years, was identified. Their electronic notes were then reviewed.ResultsTen patients were identified. Nine patients had a fever lasting 5 days or more. Four patients had either 5/5 or 4/5 of the diagnostic criteria for KD and were diagnosed with complete KD. The remaining six patients were suspected to have incomplete KD. 7/10 patients received IVIG within 10 days of onset of illness. Patients suspected to have incomplete KD experienced a mean delay in administration of IVIG of 5.3 days compared with those with complete KD. In four patients, an alternative diagnosis was established. Three patients had coronary artery abnormalities on first echocardiogram. From these patients, only one had a follow-up echocardiogram recorded in their notes. No patient had more than one follow-up echocardiogram (at both 2 and 6 weeks).ConclusionIdentifying patients with incomplete KD is more difficult than identifying those with complete KD and any delay in giving IVIG could be due to this reason. This audit suggests that increasing awareness of incomplete KD and a clear guideline will aid prompter diagnosis and administration of IVIG. This audit also suggests that all patients with KD should receive more than one follow-up echocardiogram.

Kawasaki Disease Arab Initiative [Kawarabi]: Establishment and Results of a Multicenter Survey

“…The previously observed delayed diagnosis in Arabic countries highlights the need of national awareness and epidemiological studies. In fact, previous papers have suggested increased awareness might be associated with prompter diagnosis of KD [ 41 ]. The current survey showed that the awareness and knowledge about KD among the general population is low despite having a high level of awareness among the medical community.…”