Year: 2026 | Month: January | Volume: 16 | Issue: 1 | Pages: 261-269
DOI: https://doi.org/10.52403/ijhsr.20260130
Kawasaki Disease in PICU: Clinico-Epidemiological Profile and Inflammatory Markers – Experience from a Tertiary Care Centre in Eastern India
Mrinmoy Roy1, Debadatta Mukhopadhyay2, Manoj Kumar Das3, Dilip Paul4
1Department of Pediatrics,
1,2,4BCRPGIPS, West Bengal University of Health Sciences, 3ESIC Joka, Kolkata, India.
Corresponding Author: Debadatta Mukhopadhyay
ABSTRACT
Kawasaki disease in children is the commonest acquired heart disease inchildren. It still remains an enigma and poses a diagnostic dilemma especially in incomplete oratypical cases and in critically ill children.This study was done to evaluate the clinico-epidemiological spectrum, inflammatory markers, and outcomes of children with Kawasaki Disease (KD) admitted in PICU, identify the factors associated with severity and outcome of of these children and compare clinical and Lab parameters of children with KD in PICU and those in ward and didn’t require ICU care.
Methods: This was a prospective observational study conducted over 18 months in the pediatric intensive care unit (PICU) of a tertiary care hospital in Eastern India. Children diagnosed with KD were divided into two groups: those requiring PICU admission and those managed in wards. Demographic data, clinical features, laboratory parameters, echocardiographic findings, treatment, and outcomes were analyzed.
Results: A total of 45 KD patients were studied, of whom 15 required PICU admission and 30 were managed in wards. Mean age was comparable (3.66 ± 3.51 vs. 2.99 ± 2.50 years, p = NS). PICU patients had significantly higher leukocyte counts (20,663 vs. 16,080/mm³, p = 0.004), lower platelet counts (2.47 vs. 3.03 lakh/mm³, p = 0.009), and significantly elevated inflammatory markers—CRP (91.4 vs. 30.7 mg/dL, p < 0.0001), ESR (64.9 vs. 32.2 mm/hr, p < 0.0001), ferritin (1044 vs. 333 ng/mL, p < 0.0001), LDH (1352 vs. 457 U/mL, p < 0.0001), NT-proBNP (25,293 vs. 2580 pg/mL, p < 0.0001). Echocardiography revealed coronary dilatation in all PICU patients, with left ventricular dysfunction in 73.3% and pericardial effusion in 20%.
Two patients (13%) died, both with markedly elevated NT-proBNP and LDH levels. (diagnosed as KD followed by HLHS progressing to multiorgan dysfunction) 7(47%) were diagnosed as KD shock syndrome (KDSS), 6 (40%) with myocarditis (of which one had SVT).
Conclusion: Elevated CRP, ESR, ferritin, LDH, and NT-proBNP are associated with severe KD requiring PICU care. NT-proBNP and LDH levels also correlated with mortality. Early recognition of these markers may guide timely interventions in resource-limited settings.
Key words: Kawasaki disease, pediatric intensive care, NT-proBNP, inflammatory markers, coronary dilatation