Publication:

Clinico-hematological profile and coronary artery changes detected at initial echocardiography in children with Kawasaki disease: a 12 years single centered experience from a tertiary care referral center of Bangladesh

Background Kawasaki disease (KD) is the most common cause of acquired heart disease in childhood. Coronary artery abnormalities may occur in 15-25% of children with KD. Our study aimed to analyze the demographic, clinical, laboratory profile and initial echocardiographic changes of coronary arteries among KD patients admitted in a tertiary care center in Bangladesh.

Methods This was a retrospective study of 66 children diagnosed with KD admitted in the Department of Paediatrics from July 2010 to March 2023 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Results We found that 51.5% patients had complete KD while 48.5% had incomplete KD. Clinical profile showed fever, extremity changes, oral mucosal changes, maculopapular rash, cervical lymphadenopathy and non-purulent conjunctivitis in 100%, 72.7%, 68.2%, 62.1%, 50% and 48.5% cases respectively. Echocardiography done at the time of diagnosis demonstrated coronary artery abnormalities among 48.5% cases. Overall, 15.2% cases had small aneurysms, 7.6% patients had medium aneurysms and 4.5% cases had large or giant aneurysms in our study. Majority of the patients had developed LCA abnormalities (42.4%) followed by RCA abnormalities in 21.2% cases and LCX abnormalities in 7.6% cases.

Conclusions In this study, we observed a slightly higher frequency of the complete KD (51.5%) in comparison to incomplete KD patients. Fever was the most consistent clinical feature followed by extremity changes, oral mucosal changes, maculopapular rash, cervical lymphadenopathy and lastly non-purulent conjunctivitis. Initial echocardiography revealed 48.5% patients with KD had coronary artery abnormalities with a predilection towards left coronary artery.