Evaluation of Kawasaki Disease Cases in A Tertiary Care Center in Terms of Diagnosis, Treatment, and Complications

INTRODUCTION: Kawasaki disease (KD) is the leading cause of acquired heart disease in children, and timely diagnosis is crucial to prevent cardiac complications. We aimed to evaluate the clinical and demographic characteristics of patients diagnosed with KD, reveal differences between complete and incomplete cases, and determine risk factors associated with cardiac involvement.
METHODS: This retrospective study included 30 patients who were diagnosed with KD. Patients were classified as having complete KD (cKD) or incomplete KD (iKD) based on standard diagnostic criteria. Statistical analyses, including logistic regression and receiver operating characteristic (ROC) analysis, were performed to explore the predictors of cardiac involvement.
RESULTS: The study included 30 patients (73.3% male, n=22). 70% of the patients had cKD. Cardiac involvement was found in 40% of patients, with mitral regurgitation and coronary artery dilatation being the most common. Patients with cKD had a longer duration of fever (p=0.047), higher C-reactive protein (p=0.018) and alanine aminotransferase levels (p=0.044), lower hemoglobin levels (p=0.029), and more frequent cardiac involvement (p=0.049) than those with iKD. The duration of fever was significantly higher in those with cardiac involvement (p=0.035). ROC analysis identified fever duration as a significant predictor of cardiac involvement (area under the curve=0.727, p=0.038), with an optimal cutoff of 3.5 days yielding 91.7% sensitivity and 72.2% specificity.
DISCUSSION AND CONCLUSION: Fever duration, particularly over 3.5 days, is strongly associated with cardiac complications in KD. These findings highlight the need for early recognition and timely treatment to improve cardiovascular outcomes.

Keywords: Coronary aneurysm, diagnosis, fever, mitral valve insufficiency, Mucocutaneous lymph node syndrome.