Related Experiment Videos
Delayed diagnosis of Kawasaki disease: risk factors and outcome of treatment
R Sittiwangkul1, Y Pongprot, S Silvilairat
1Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Thailand. rsittiwa@med.cmu.ac.th
Insights
Delayed diagnosis of Kawasaki disease (KD) in Thailand significantly increases the risk of coronary artery abnormalities (CAA). Early detection and treatment are crucial for better outcomes in children with KD.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease (KD) can lead to coronary artery aneurysms in untreated children.
- Intravenous immunoglobulin (IVIG) treatment within 10 days of illness significantly reduces coronary artery abnormalities (CAA).
- Limited data exists on delayed KD diagnosis in Thailand.
Purpose of the Study:
- To investigate the prevalence, risk factors, and outcomes of delayed KD diagnosis in Thai patients.
- To assess the impact of delayed diagnosis on the development of CAA.
Main Methods:
- Retrospective review of 170 KD patients diagnosed between 2000-2008 at Chiang Mai University Hospital.
- Patients categorized into Group I (diagnosed ≤10 days of fever) and Group II (diagnosed >10 days of fever).
- Comparison of clinical characteristics, laboratory results, and CAA incidence between the two groups.
Main Results:
- 20 patients (11.7%) were diagnosed after 10 days of fever (Group II).
- Group II showed a significantly higher incidence of CAA (75% vs 19%, p<0.001).
- Delayed diagnosis was associated with more severe CAA and higher rates of treatment resistance.
Conclusions:
- Delayed KD diagnosis in Thai patients is linked to a higher risk of CAA and poorer outcomes.
- Increased awareness among healthcare providers regarding KD, particularly in young children or those with incomplete symptoms, is essential.
- Timely diagnosis and treatment are critical for preventing severe cardiac complications in Kawasaki disease.
Background:
Kawasaki disease (KD) is associated with a high incidence of coronary artery aneurysms in untreated children. Treatment with intravenous immunoglobulin (IVIG) within the 1st 10 days of illness reduces by approximately fivefold the prevalence of coronary artery abnormalities (CAA). Data regarding delayed diagnosis of KD in Thailand have not been reported in the literature.
Aims:
To determine the prevalence, risk factors and outcome of delayed diagnosis of KD in Thai patients.
Methods:
We retrospectively reviewed the medical records of patients at Chiang Mai University Hospital diagnosed as KD during 2000-2008. Patients were classified into two groups: Group I were diagnosed ≤10 days of fever and Group II were diagnosed >10 days of fever.
Results:
Of 170 patients, 150 were in Group I [mean (SD) fever 7 (1·45) d] and 20 (11·7%) in Group II [mean (SD) fever 15 (4) d]. There were no statistical differences between the two groups in age, gender, number of KD clinical manifestations or laboratory results, except that Group II were of lower weight (p = 0·01). Group II were younger (p = 0·09) and had more incomplete criteria (p = 0·09) but the differences were not statistically significant. Group II had a higher incidence of CAA (75% vs 19%) (p<0·001), more severe CAA and more resistant cases (31·2% vs 9·5%) (p = 0·04).
Conclusion:
Patients with delayed diagnosis of KD have a higher risk of developing CAA and of a more severe outcome for coronary artery disease. Education is needed to make healthcare providers and physicians more aware of KD, especially in small children or those with incomplete KD.
Related Concept Videos
01:26Rocky Mountain Spotted Fever
01:21Rheumatic Heart Disease III: Medical Management
01:18Endocarditis III: Medical Management
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:15Aortic Regurgitation I: Introduction