A Five Year Retrospective Study of Kawasaki Disease in Children admitted to Parami General Hospital

Introduction

• Kawasaki disease is an acute febrile necrotizing vasculitis of the medium and small-sized vessels,
• Formerly known as mucocutaneous lymph node syndrome or infantile polyarteritis nodosa,
• first described by Dr. Tomisaku Kawasaki in Japn in 1967
• Leading cause of Acq; Ht Dis in Developed countries

Diagnostic criteria

Accepted criteria from CDC,
A patient with fever of
5 or more days and the presence of
at least 4 of the following 5 clinical signs:

• Perdominantly occurring in children aged 6 months-5 years,
• The importance of this disease is a life threatening condition to involve coronary arteries and development of Acquired Ht Dis:
• A Pneumonic FEBRILE
  
• Fever
• Peripheral Extremities changes – Erythema, Edema,
• Buccal mucosa changes,
• Rash
• I (gnore),
• Cervical Lymphadenopathy (at least 1.5 cm in diameter),
• Eyes – Bilateral Nonpurulent conjunctivitis

• Non sepcific CF in order of frequency
• Irritability
• Reduced intake
• Corysal symptoms
• Abdo pain
• Jt pain

Etiology

Unknown

Several Hypothesis

Infectious
immune
Genetic

Method

• Hospital based retrospective cohort descriptive study of children diagnosed with Kawasaki Disease from 2012 – 2017.
• Supportive Lab: Findings
• Thrombocytosis
• Neutrophilia
• Raise CRP & ESR
• Anemia
• CXR = 50% abnormalities
• USG abdo = Hydrop of the GB

Aim of study

( 1 ) To review the profile of confirmed cases of KD admitted to Parami General Hospital in last 5 years.

( 2 ) To analyze the treatment and outcome of KD cases

Age and age group distribution preschool children of 3.5mo to 59 mo with mean& median age of 19.1mo & 14mo

Fig 5 – Distribution of presenting symptoms in order of frequency

On Fol:up

All children were recovered from their dis : without residual damage of CA.

1 pt with giant CA aneurym needed aspirin for 3 yrs and now he is also normal CA.

• Satisfactory outcome with early diagnosis and proper timely treatment with IVIG can prevent serious coronary complications.
• We did the Echo in all children
• Echo findings showed
  4 ( 26.7%)-minimal pericardial effusion
  1 (6.6%) patient – Right Coronary Artery Dilatation
  9 (60%) – relatively normal finding

Conclusion

• One should aware of KD in differential diagnosis of a child presented with feer and rash as it can mimic other common diseases like measles, scarlet fever, stevens-johnson Syndrone, juvenile rheumatoid arthritis, bac cervical lymphadenitis ect.
• Reason for presentation
  To raise awareness of KD so that it could be included as a D DX of common febrile conditions in children not responding satisfactorily to conventional therapies.

Thank you for your attention!