PT  - JOURNAL ARTICLE
AU  - Beth Pascall
AU  - Arjuna Thakker
AU  - Ying Foo
AU  - Pradip Thakker
TI  - Immunoglobulin for Kawasaki disease: a 3-year retrospective audit
AID  - 10.1136/bmjpo-2019-000451
DP  - 2019 Sep 01
TA  - BMJ Paediatrics Open
PG  - e000451
VI  - 3
IP  - 1
4099  - http://bmjpaedsopen.bmj.com/content/3/1/e000451.short
4100  - http://bmjpaedsopen.bmj.com/content/3/1/e000451.full
SO  - BMJ Paediatrics Open2019 Sep 01; 3
AB  - Aim To evaluate whether intravenous immunoglobulin (IVIG) use in children with suspected Kawasaki disease (KD) was given according to local trust and the newly revised American Heart Association (AHA) guidelines.Methods In our tertiary hospital, any child with suspected KD given IVIG, over the past 3 years, was identified. Their electronic notes were then reviewed.Results Ten patients were identified. Nine patients had a fever lasting 5 days or more. Four patients had either 5/5 or 4/5 of the diagnostic criteria for KD and were diagnosed with complete KD. The remaining six patients were suspected to have incomplete KD. 7/10 patients received IVIG within 10 days of onset of illness. Patients suspected to have incomplete KD experienced a mean delay in administration of IVIG of 5.3 days compared with those with complete KD. In four patients, an alternative diagnosis was established. Three patients had coronary artery abnormalities on first echocardiogram. From these patients, only one had a follow-up echocardiogram recorded in their notes. No patient had more than one follow-up echocardiogram (at both 2 and 6 weeks).Conclusion Identifying patients with incomplete KD is more difficult than identifying those with complete KD and any delay in giving IVIG could be due to this reason. This audit suggests that increasing awareness of incomplete KD and a clear guideline will aid prompter diagnosis and administration of IVIG. This audit also suggests that all patients with KD should receive more than one follow-up echocardiogram.