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Kawasaki disease and the emerging coronary artery disease epidemic in India: is there a correlation?
Surjit Singh1, Roosy Aulakh, Tomisaku Kawasaki
1Pediatric Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India, surjitsinghpgi@hotmail.com.
Insights
Kawasaki disease (KD) is underdiagnosed in India, potentially leading to coronary artery abnormalities and future heart problems. Early diagnosis and treatment are crucial for preventing long-term cardiovascular risks in children.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Kawasaki disease (KD) is increasingly reported in India, but a significant number of cases remain undiagnosed.
- Undiagnosed KD in childhood can lead to coronary artery abnormalities, increasing the risk of myocardial ischemia in adulthood.
Purpose of the Study:
- To highlight the underdiagnosis of Kawasaki disease in India.
- To emphasize the potential link between childhood KD and the rising prevalence of coronary artery disease (CAD) in India.
Main Methods:
- Utilized incidence data from a Chandigarh study (4.54/100,000 children <15 years).
- Extrapolated national incidence to estimate the minimum number of annual KD cases in India.
- Reviewed potential long-term cardiovascular consequences of undiagnosed KD.
Main Results:
- Estimated minimum of 17,417 new Kawasaki disease cases annually in India.
- A significant proportion of undiagnosed children are at risk for coronary artery abnormalities.
- Undiagnosed childhood KD may contribute to the growing burden of coronary artery disease (CAD) in India.
Conclusions:
- Kawasaki disease is likely significantly underdiagnosed in India.
- Missed KD diagnoses in childhood should be considered in adults with CAD, especially those without typical risk factors or family history.
- Increased awareness and improved diagnostic strategies for KD are essential in India to mitigate future cardiovascular disease burden.
Abstract:
Although Kawasaki disease (KD) is now being increasingly reported from India, the vast majority of children with KD are still not being diagnosed and treated. A recent study from Chandigarh has shown that the incidence of KD is at least 4.54/100,000 children below 15 y of age. Extrapolations of this figure suggest that a minimum of 17,417 new cases of KD would be occurring every year in our country. A significant proportion of these children may develop coronary artery abnormalities. These children would then be at risk of developing myocardial ischemia as young adults. It is authors' contention that (undiagnosed) KD in childhood may be contributing to the growing pool of coronary artery disease (CAD) in India. Similarly, a missed diagnosis of KD in childhood should be considered as a possibility while evaluating adults with CAD, especially when there are no overt risk factors and no family history of the disease.
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