194 - PROFILE OF KAWASAKI DISEASE WITH CORONARY ARTERY ANEURYSMS: DATA FROM A TERTIARY CARE CENTRE IN EASTERN INDIA

Aims and Objectives: To study the clinico-epidemiological profile, baseline investigations, treatment given and response to therapy in patients diagnosed as Kawasaki Disease with Coronary Artery Aneurysms (CAA) and compare the findings with those without CAA 

Methods: This is a retrospective  study on patients diagnosed as Kawasaki disease with CAA and without CAA as per AHA 2017 guidelines,  from a tertiary care center in  Eastern India. The study period was January 2020 to August 2023

Results: 108 patients were diagnosed as KD during this study period of whom 101 patients were included (7 were excluded because of incomplete data). The epidemiological profile and median investigations of patients who had CAA versus those who did not have been described in Table 1.

39/101 (38.6%) patients developed CAA at diagnosis or follow up of whom 35 (34.7% of 101) had aneurysms at diagnosis. 23 patients (59%) had small CAA, 14 (36%) had medium CAA and 2 (5%) had giant CAA.

All patients who had small CAA regressed on follow up.

Amongst the 14 patients who had medium CAA, 1 had intraluminal thrombus formation, 12 received anticoagulants, 6 have completely regressed, 1 had persistent aneurysm at 6 month follow up. 7 patients presenting over the last 6 months have achieved partial regression.

Two patients who had late diagnosis around 2 weeks had giant aneurysms, received Infliximab plus steroids and Cyclosporine along with anticoagulants. One has significant reduction in size (presently +3Z) whereas the other is lost to follow up.

Conclusion: Infants have a higher incidence of medium and large CAA. Those with giant CAAs had a later diagnosis. Thus infantile onset disease and diagnosis beyond 10 days of onset were associated with larger CAAs at diagnosis.

In comparison to data till 2019 where the incidence of CAAs were 21% , since 2020 there has been a manifold increase of CAAs to 38.6% with increasing number of children presenting with CAAs at diagnosis. The number of giant CAAs have however reduced from 3% to 1.6%.