Abstract 183: Mortality in children with Kawasaki disease: 20 years of experience from a tertiary care centre in North India.

Abstract

Background: Kawasaki disease (KD) is a common vasculitic disorder of childhood. Reported mortality in KD in the West is 0.08 %. We report clinical profile of 4 children who succumbed to KD during 1994-2014 at Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research Centre, Chandigarh, India. To the best of our knowledge, this is the first report on mortality in KD from any developing nation. Objectives: To study the clinical and laboratory profile of 4 children with KD who died at our centre. Methods: During the period 1994-2014, a total of 415 children were diagnosed to have KD based on American Heart Association criteria. M:F ratio was 1.9:1 and 96 children were aged 2 years or less. Children with KD received 2 g/kg of intravenous immunoglobulin (IVIg) and 50-80 mg/kg/day of aspirin initially and 3-5 mg/kg/day later. 2-D echocardiography was done once during the acute phase and then 6-8 weeks later on follow up. 4 amongst these died and their details were analysed by study of clinical records. Results: We report 4 deaths (2 boys, 2 girls) in this cohort of 415 children with KD. All 4 were below 2 years of age and had had significant delays in diagnosis and referral (Table). Symptomatic myocarditis was noted in 2 children, while 2 of them had thrombocytopenia. Conclusion: We report a mortality of about 1% in children with KD. Delays in diagnosis and referral contributed significantly to this mortality.