Outcomes of Kawasaki Disease in Samutsakhon Hospital: A Retrospective Descriptive Study
Keywords:
Kawasaki disease, Echocardiography, IVIG-Resistance, Coronary AneurysmAbstract
Background: Kawasaki disease (KD) is a medium-vessel vasculitis in children that, if left untreated, can lead to coronary artery aneurysms in up to 25% of cases. The 2024 American Heart Association (AHA) guidelines introduce more stringent recommendations, including increased frequency of echocardiographic monitoring for high-risk groups and adjusted therapeutic regimens. However, implementing these guidelines in Samutsakhon Hospital remains challenging due to resource constraints.
Objective: The primary objective was to evaluate changes in coronary artery size by comparing initial findings (1–2 weeks) with post-treatment results (4–8 weeks), to study the clinical epidemiology and natural course of KD at Samutsakhon Hospital.
Methods: The study design is descriptive retrospective study. Medical records of patients aged 1 month to 15 years diagnosed with KD and followed up at Samutsakhon Hospital from January 2021 to December 2024 were reviewed. Data collected included baseline characteristics, clinical manifestations, relevant laboratory results, and coronary artery dimensions measured by echocardiography at two intervals: 1–2 weeks and 4–8 weeks post-diagnosis. Statistical analysis was performed on the compiled data.
Results: A total of 28 patients were included, with a median age of 16 months and a female predominance (60.7%). incomplete KD was observed in 64.3% of cases, and the IVIG-resistance rate was 21.4%. The median duration of fever before receiving IVIG was 6 days. The IVIG-resistance group showed a significantly higher incidence of coronary artery dilation and aneurysms compared to the IVIG-responsive group (p=0.019, p=0.029). However, follow-up echocardiography demonstrated that all small and medium-sized aneurysms regressed to normal dimensions within 8 weeks of treatment.
Conclusion: KD patients at Samutsakhon Hospital exhibited a higher proportion of incomplete KD and IVIG-resistance than typical epidemiological data suggest. Rapid diagnosis and close echocardiographic monitoring during the first 6–8 weeks are crucial for evaluating coronary artery changes.
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