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Retrospective analysis of children diagnosed with Kawasaki disease
Fatih Varol1, Reyhan Dedeoğlu2, Aziz Kiliç3
1Department of Pediatric Intensive Care, University of Health Science Sancaktepe Şehit Profesör Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkiye.
Insights
Delayed intravenous immunoglobulin (IVIG) therapy in Kawasaki disease is linked to coronary artery abnormalities. Prompt treatment is crucial for preventing coronary artery aneurysm (CAA) and long-term complications.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease (KD) is a critical pediatric illness.
- Coronary artery abnormalities are a significant long-term complication of KD.
Purpose of the Study:
- To evaluate the long-term impacts of Kawasaki disease.
- To analyze coronary involvement, demographics, treatment, and clinical course in KD patients.
Main Methods:
- 104 KD patients were hospitalized and categorized into three groups based on coronary artery involvement (no findings, dilatation, or aneurysm).
- Data collected included demographics, fever duration, inflammatory markers (CRP, WBC, neutrophils), echocardiographic findings, and time to intravenous immunoglobulin (IVIG) initiation.
Main Results:
- Patients with coronary artery aneurysm (CAA) had longer fever duration and higher C-reactive protein (CRP), white blood cell (WBC), and neutrophil counts.
- Delayed IVIG initiation (median 9.5-10 days) was observed in patients with coronary artery dilatation and CAA compared to those without.
- Lower strain deformation values were noted in patients with CAA.
Conclusions:
- Elevated CRP, WBC, and neutrophil counts correlate with coronary artery abnormalities in KD.
- The timing of IVIG administration is a critical factor in preventing coronary artery aneurysm development in Kawasaki disease.
Background:
The aim of our study was to evaluate the long-term impacts of Kawasaki disease on our patients regarding coronary involvement demographic characteristics, treatment regimens, and clinical course.
Methods:
Our study included 104 patients diagnosed and hospitalized with Kawasaki disease in our center, from January 2004 to January 2019. In our study, patients were divided into three groups according to coronary artery involvement. Patients in group 1 had no echocardiographic findings, while the ones in group 2 had coronary artery dilatation and ones in group 3 had coronary artery aneurysm (CAA).
Results:
Among 104 patients, the median age was 9.15 (3.0-22.0) years, and 61 of the patients were male while 43 of the patients were female. With a wide range of 1.50-16.50 years of follow-up time, the median diagnosis age of our patients was 31 months (3.0-164.0). Fever duration (median day 10 (5-21), p = 0.025) was statistically significantly higher in group 3. Blood C-reactive protein (CRP) levels, white blood cell (WBC) counts, and neutrophil counts were significantly higher in group 3. There was a statistically significant difference between patients in group 3 and group 2 in which the lowest strain deformation values were in the patients of group 3. In contrast to group 1, the time for initiation of IVIG therapy is significantly prolonged both in group 2 (median: 9.5 days, p = 0.028) and group 3 (median: 10 days, p = 0.036).
Discussion:
In our study, serum CRP levels, WBC count, and neutrophil count were higher in patients with coronary artery abnormalities, in agreement with the previous studies. In the light of our results, we consider that the most important determining factor for the development of coronary artery aneurysm is the time of intravenous immunoglobulin (IVIG) administration.
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