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Prolonged Fever as a Predictor of Coronary Artery Aneurysms Among Children With Kawasaki Disease in North India
Sumati Verma1, Gurdeep S Dhooria1, Puneet A Pooni1
1From the Department of Pediatrics.
Insights
Kawasaki disease (KD) can cause coronary artery abnormalities (CAAs) in children, especially with prolonged fever. Early diagnosis and treatment are crucial for preventing long-term complications.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is a significant cause of acquired heart disease in children.
- A retrospective study reviewed 50 KD patients over five years to understand disease characteristics and outcomes.
Purpose of the Study:
- To analyze the clinical presentation, coronary artery abnormalities (CAAs), and treatment outcomes in a cohort of pediatric patients with Kawasaki disease.
- To identify factors associated with the development of CAAs in KD.
Main Methods:
- Retrospective analysis of medical records from 50 children diagnosed with Kawasaki disease between 2020 and 2024.
- Data collected included clinical features, echocardiographic findings, treatment, and follow-up outcomes.
Main Results:
- Fever lasting over 7 days and younger age were significantly associated with CAAs (66% prevalence).
- Common CAAs included coronary dilatation and aneurysms of varying sizes, predominantly affecting left-sided coronary arteries.
- Most patients received intravenous immunoglobulin and aspirin, with most CAAs resolving or regressing on follow-up echocardiography.
Conclusions:
- Prolonged fever (>7 days) in children warrants consideration for Kawasaki disease due to its correlation with coronary abnormalities.
- Early diagnosis and prompt treatment are essential to mitigate the risk of developing persistent coronary artery abnormalities and associated morbidity.
Background:
This is a retrospective study to report our experience with a cohort of 50 patients with Kawasaki disease (KD) over 5 years.
Method:
The study was conducted in the Department of Pediatrics. Data were retrieved from the medical records of patients admitted with KD collected from 2020 to 2024 and analyzed.
Results:
Fifty children were included (male:female = 3.1:1; median age 2.6 years). Fever was universal, with a median duration of 7.5 days. Oral mucosal changes (68%) and rash (64%) were the most common clinical features. Coronary artery abnormalities (CAAs) were detected in 33 children (66%), comprising coronary dilatation (12.1%), small aneurysms (54.6%), medium aneurysms (24.2%), and giant aneurysms (9.1%). Left-sided coronary involvement, particularly of the left main and left anterior descending arteries, predominated and was associated with persistence of aneurysms on follow-up. Younger age and prolonged fever (>7 days) were significantly associated with CAAs ( P < 0.05), while other classical clinical features showed no significant correlation. All patients received intravenous immunoglobulin and aspirin. Follow-up echocardiography was available in 72% of patients; 69.7% showed complete resolution of CAAs, while 30.3% had persistent but regressing aneurysms. No fatality or any long-term adverse effects were observed on follow-up.
Conclusion:
The disease needs to be considered as a differential diagnosis in an acute febrile illness in children persisting up to 5 days. Fever >7 days is significantly correlated with coronary abnormalities. Hence, early diagnosis is important to prevent morbidity.
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