Echocardiography Follow-Up Duration in Kawasaki Disease Patients

For a study, researchers sought to determine the best period of echocardiographic follow-up in individuals with Kawasaki illness who did not have an initial coronary aneurysm. They analyzed the outcomes of follow-up echocardiography in children with Kawasaki illness participating in a children’s hospital’s Prospective Observational Study on Stratified Treatment with Immunoglobulin Plus Steroid Efficacy for Kawasaki Disease. The absence of coronary aneurysms, defined as a maximum z-score (Zmax) of 2.5 in the proximal right coronary artery and the proximal left anterior descending artery within 9 days after therapy beginning, was the primary enrolment criterion. The primary outcome was Zmax at up to 5 years of follow-up echocardiography. 

Prednisolone with intravenous immunoglobulin was given to 106 (27.5%) of 386 patients as first-line treatment, and 57 (14.8%) had a poor response. At one month, echocardiography revealed 9 patients with a Zmax of 2, including 3 (0.8%) with coronary aneurysms requiring extra antithrombotic medication and monitoring. In addition, 7 patients (1.8%) with normal echocardiographic findings at 1 month but a Zmax 2 later were lost to follow-up, 5 achieved spontaneous resolution, and none required any therapy adjustment.

In individuals with no early coronary aneurysms and a Zmax 2 at 1 month, the best period of echocardiographic follow-up may be one month. Coronary artery anomalies found after 1 month are uncommon and usually benign in the patient population.

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