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Indian Academy of Pediatrics Position Paper on Kawasaki Disease

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Abstract

Objective

To formulate practice guidelines on diagnosis and management of Kawasaki disease (KD) for Indian children.

Justification

KD is a systemic vasculitis that predominantly affects infants and children less than 5 years of age. Coronary artery abnormalities (CAA) develop in around 15–25% of untreated children with KD. Coronary artery involvement can lead to long-term cardiovascular implications such as development of premature coronary artery disease. Diagnosis of KD is essentially clinical based on recognition of a constellation of characteristic symptoms and signs. Timely diagnosis and initiation of intravenous immunoglobulin (IVIG) therapy is known to produce five-fold reduction in the incidence of CAA. As there is no confirmatory laboratory test for KD, the diagnosis may be missed if one is not familiar with the nuances of clinical diagnosis.

Process

A committee was formed under the auspices of Indian Academy of Pediatrics in early 2018 for preparing guidelines on KD in Indian children. A meeting of the consultative committee was held in Mumbai, and a draft protocol was devised. All members scrutinized the recent publications on the subject and an attempt was made to arrive at a broad consensus. Published guidelines on the subject were also reviewed.

Recommendations

The diagnosis is clinical and is aided by laboratory and 2D echocardiography. First line of therapy is IVIG, and should be started expeditiously once the diagnosis is made.

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Author information

Authors and Affiliations

  1. From Department of Pediatrics, Manipal Hospitals, Bangalore, Karnataka, India

    Bhaskar Shenoy

  2. From Department of Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Surjit Singh

  3. Department of Cardiology, Pushpagiri Medical College, Tiruvalla, Kerala, India

    M. Zulfikar Ahmed

  4. Department of Pediatric Rheumatology, Institute of Child Health, Kolkata, West Bengal, India

    Priyankar Pal

  5. Department of Rheumatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India

    Suma Balan

  6. Jupiter Hospital, Thane, Maharashtra, India

    Vijay Viswanathan

  7. Aster CMI Hospital, Bangalore, Karnataka, India

    Sagar Bhattad

  8. Manipal Hospitals, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India

    Anand P. Rao

  9. Department of Cardiology, Manipal Hospital, Bangalore, Karnataka, India

    Maitri Chaudhuri

  10. Killol Children Hospital, Surat, Gujarat, India

    Digant D. Shastri

  11. AJ Institute of Medical Sciences, Mangalore, Karnataka, India

    Santosh T. Soans

Authors
  1. Bhaskar Shenoy
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  2. Surjit Singh
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  3. M. Zulfikar Ahmed
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  4. Priyankar Pal
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Corresponding author

Correspondence to Bhaskar Shenoy.

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Shenoy, B., Singh, S., Ahmed, M.Z. et al. Indian Academy of Pediatrics Position Paper on Kawasaki Disease. Indian Pediatr 57, 1040–1048 (2020). https://doi.org/10.1007/s13312-020-2033-1

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  • DOI: https://doi.org/10.1007/s13312-020-2033-1

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