Profile of paediatric tertiary hospital-referred patients with Kawasaki disease in western Australia: 2004 to 2019

Background: Kawasaki disease (KD) is an acute systemic vasculitis of childhood, with an increasing incidence worldwide [1]. We aim to describe the clinical profile of children diagnosed with KD, referred to the only paediatric tertiary cardiac service in Western Australia (WA) over a 16-yearperiod.

Methods: A retrospective cohort study was completed of children diagnosed with KD and reviewed by the Princess Margaret Hospital/Perth Children’s Hospital Cardiology service for an echocardiogram between January 2004 and December 2019. Data was collated from medical records and electronic cardiology databases.

Results: 352 patients with KD were identified. 220 (62.5%)patients were male and 132 (37.5%) female, with 40.6% of Asian ethnicity. Median age of presentation was 38 months(interquartile range 43 months) with 255 (72.4%) patients presenting younger than 5 years of age. Incomplete criteria for diagnosis was evident in 101 patients (28.7%). 92.6% of patients were commenced on aspirin and 86.9% were treated with intravenous immunoglobulin. 71 patients (20.2%) had coronary artery abnormalities at initial echo. No cases required cardiac surgical intervention. 13 patients warranted ICU admission for clinical instability.

Conclusions: The profile of KD in this study is reflective of the statewide presentations. Rates of CA involvement in this cohort are comparable to published literature. 28.7% patients presenting with incomplete criteria highlights the need for vigilance with the diagnosis.