CLINICAL PROFILE AND BIOMARKER ANALYSIS IN KAWASAKI DISEASE: A PROSPECTIVE COHORT STUDY FROM NORTH INDIA

Abstract

Objective: To study the clinical profile, biomarker patterns, and cardiovascular outcomes of children admitted with Kawasaki Disease (KD) at a tertiary care center in Shimla. Study Design: Prospective observational cohort study. Participants: 29 children aged 2 months to 18 years admitted to the pediatric ward with a diagnosis of Complete or Incomplete KD. Methods: Clinical history, physical examination, and laboratory parameters were recorded. Coronary artery status was assessed by 2D-Echocardiography at discharge and at 3-months follow-up. Results: The mean age of the cohort was 46.4 months with a male-to-female ratio of 1.23:1. Only 41.4% of patients met the criteria for Classic KD, while the majority (58.6%) presented with Non-Classic (Incomplete or Atypical) forms. Oral mucosal changes (93.1%) and cervical lymphadenopathy (65.5%) were the most consistent clinical features, whereas polymorphous rash (51.7%) and conjunctivitis (41.4%) were less frequent. Male gender was significantly associated with the Incomplete phenotype (87.5%). Coronary artery dilatation was observed in 82.8% of patients at discharge; however, 93.1% of these normalized by the first follow-up, indicating transient ectasia. IVIG resistance was observed in only 3.6% of treated patients. Biomarker analysis revealed elevated mean Procalcitonin (3.28 ng/mL) and D-Dimer levels (1075 ng/mL). Conclusion: Non-classic presentations of KD are predominant in this setting, often lacking classic mucocutaneous signs like rash. Despite a high incidence of acute coronary involvement (82.8%), the long-term prognosis is favorable with timely therapy, as most lesions represent transient ectasia.