Carolinas Research Day 2021

Clinical Studies

06 The Impact of Early Intravenous Immunoglobulin Treatment on Coronary Artery Disease in Children with Kawasaki Disease

MacKenzie LeMay, OMS IV, Hanna S. Sahhar, MD, FAAP, FACOP, Ning Cheng, PhD, Jessica Resnick, OMS III, Lucas Hooks, OMS III

Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg Regional Healthcare System

Introduction: Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown cause that has an affinity for negatively impacting the coronary arteries of infants and young children. Common cardiac complications include coronary artery aneurysms, depressed myocardial contractility and heart failure may develop. If left untreated, about 25% of patients will develop coronary artery disease (CAD) or coronary lesions. Intravenous immunoglobulin (IVIG) treatment reduces morbidity and mortality related to cardiac involvement, however, how quickly results are seen is unknown. This retrospective study looked at CAD outcomes for KD pediatric patients in a community- based hospital in South Carolina who were treated with IVIG between five and ten days of initial fever. In the first phase of this study, there was CAD found in about half the patients studied and had 1 year follow up echocardiograms. In this larger scope of patients

we found less CAD at presentation so have taken a closer look at the medications provided. Hypothesis: 1. Diagnosis and IVIG treatment prior to ten days of fever in KD patients (ages between 5 months and 7 years old) will be associated with no statistically significant increase in coronary artery disease. 2. There will be no antibiotic usage due to length of fever, standard of care recommendations to Kawasaki Disease, and standard guidelines for antibiotic stewardship. Methods: Retrospective chart review of thirty- six consecutive pediatric patients admitted to a community-based hospital in South Carolina with diagnosis of KD over a thirteen and a half-year period from September 20, 2006 to March 31, 2020.

Institutional Review Board review was exempted for this study. We did descriptive analyses on patients' demographic characteristics (age, Ethnicity (Hispanic or Latino or not), race (White, Black or African American, Asian, Native American or Pacific Islander, and other), geographic area (by zip code). We used Chi-square-test to compare patients' risk of developing CAD (yes or no) in IVIG treatment groups (<=10 days vs >10 days). We also used Chi-square- test to compare whether patients having antibody treatment (yes or no) within recommended treatment time (<=7 days vs >7 days). Results: We are still pending biostatistical analysis at this time. Conclusion: We are still pending biostatistical analysis at this time.

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