Early Diagnosis and Cardiac Complications of Kawasaki Disease in a Resource-Limited Regional Hospital

Introduction Kawasaki disease (KD) is a type of vasculitis that mainly affects young children and is treated effectively with intravenous immunoglobulin (IVIG) when given promptly. Coronary artery aneurysm (CAA) is the most significant complication, occurring in 25% of untreated cases. However, this risk drops to 3% with IVIG treatment. This study aims to describe the clinical characteristics and cardiac complications of children diagnosed with KD at Al Rustaq Hospital (ARH). Methods A retrospective study was conducted on children under 13 years of age diagnosed with KD between January 1, 2010 and December 31, 2023. Data were retrieved from the hospital's electronic records using the ICD-10 diagnostic code and cross-checked with pharmacy records of IVIG administration. Anthropometric, clinical, radiological, and biochemical data were collected and analyzed. Results Fifty children were identified, including 27 males (54.0%). The median age at presentation was 24 months (IQR: 14-43), and the median duration of fever was four days (IQR: 3-6). Diagnosis and initiation of IVIG treatment occurred at a median of two days (IQR: 1-3). Eight children (16.0%) were resistant to the first dose of IVIG. No significant differences were found between IVIG-resistant and IVIG-responsive groups in terms of age at diagnosis, fever duration, timing of IVIG administration, CRP, serum albumin, or alanine aminotransferase levels. The median CRP level significantly decreased from 143.3 mg/L before IVIG to 62.4 mg/L after treatment (p < 0.001). Six children (12.0%) had CAA on initial echocardiography, with only three (6.0%) showing persistent CAA on follow-up echocardiography eight weeks later. No significant associations were observed between CAA development and age at diagnosis, fever duration, CRP levels, albumin levels, or timing of IVIG administration. Conclusions KD is rarely encountered in regional hospital settings. Nonetheless, patients at ARH presented early, and diagnosis and treatment were initiated promptly despite the limitations of a secondary care facility. This early recognition and rapid management likely contributed to reducing long-term cardiac complications in children with KD.