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Coronary artery dilatation in Incomplete Kawasaki disease
A P Vijayan1, K B Dinesh, K R Divia Nath
1Department of Pediatrics, Malabar Institute of Medical Sciences, Calicut 673 016, Kerala, India. drvijayan.ap@gmail.com
Indian Pediatrics
|July 30, 2009
Summary
Children with Incomplete Kawasaki disease show a higher incidence of coronary artery dilatation compared to those with Classical Kawasaki disease. This highlights the increased risk of cardiac abnormalities in incomplete KD cases.
Area of Science:
- Pediatrics
- Cardiology
- Rheumatology
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- Distinguishing between incomplete and classical KD is crucial for timely management and monitoring.
- Coronary artery abnormalities are a significant complication of KD.
Purpose of the Study:
- To compare the incidence of coronary artery dilatation in children diagnosed with incomplete versus classical Kawasaki disease.
- To evaluate the diagnostic performance of AHA criteria in detecting coronary artery dilatation in KD patients.
Main Methods:
- Retrospective review of pediatric admissions diagnosed with Kawasaki disease between 2002 and 2007.
- Inclusion of 29 patients, categorizing them into incomplete KD (12 patients) and classical KD (17 patients).
- All patients received intravenous immunoglobulin (IVIG) and underwent echocardiography for coronary assessment.
Main Results:
- Coronary involvement was significantly higher in the incomplete KD group (91.6%) compared to the classical KD group (41.1%).
- The American Heart Association (AHA) criteria demonstrated low sensitivity (39%), specificity (9%), and predictive value (41%) for detecting coronary artery dilatation.
- Incomplete KD was associated with a substantially greater risk of coronary artery abnormalities.
Conclusions:
- Children presenting with incomplete Kawasaki disease face a higher risk of developing coronary artery abnormalities.
- The current AHA diagnostic criteria may be insufficient for identifying all children at risk for coronary complications in Kawasaki disease.
- Further research is warranted to improve early detection and management strategies for incomplete Kawasaki disease to prevent cardiac sequelae.
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