Page 125 - Abstract Book KONIKA 18

Cardiology

P-CAR-017
Distribution of Congenital Heart Disease in Children with Down Syndrome

Fitriyani, Astra Parahita, Agustini Utari, Anindita Soetadji
Department of Child Health, Faculty of Medicine Universitas Diponegoro/Dr. Kariadi General Hospital,
Semarang, Central Java, Indonesia
Abstract
Background The incidence of congenital heart disease (CHD) in children with Down syndrome (DS) is
40-60%, predominantly atrioventricular septal defect (AVSD). However, a variety of CHD distribution
had been reported in several studies. Objective To determine the distribution of CHD in children with DS.
Methods We collected data from medical records on DS children referred to the pediatric cardiology division
at dr. Kariadi General Hospital Semarang during 2019 to 2020. The presence of CHD was confirmed with
echocardiography examination. Nutritional status was determined based on CDC DS growth chart 2000.
Results There were 143 of 164 (87%) children with DS confirmed having CHD. The range of aged of CHD
children from 16 days to 17 years, with 80% children was one month old to 2 years old, and equal distribution
between gender. Nutritional status showed 64.3% of children were normal, 47.6% were wasted. The single
lesion was found in 68.5% of all CHD, while 31.5% showed multiple defects. The most common type of
single lesion CHD was atrial septal defect (ASD, 52%), followed by patent ductus arteriosus (PDA, 21%)
and ventricular septal defect (14%). AVSD was found in 7% of cases. The most common multiple lesion
was ASD+PDA (34%). Clinical presentation of CHD revealed 49% asymptomatic, 28.7% failure to thrive,
and 11.9% respiratory symptoms. Murmur was heard in 76.2% of cases. Conclusion Presence of CHD was
confirmed in 87% of DS who referred to pediatric cardiologist. The most common type was ASD.
Keywords: congenital heart disease; Down syndrom

P-CAR-018
Acute Kawasaki disease in a 5-year-old Patient : A Case Report
Dara Marissa Widya Purnama , Kalis Joko Purwanto 2
1
1
General Practitioner and Department of Child Health , Handayani Hospital, Kotabumi, North Lampung, Indonesia
2
Abstract
Background Kawasaki disease is an acute self-limited vasculitis which usually occurs in children under
5 years of age. Proper diagnosis based on clinical findings are important to treat and prevent associated
complications of the disease. Objective To report a case of a girl with Kawasaki disease which rare occur
in north Lampung. Case A 5-year-old girl comes to the ER with 5 days of high fever, followed by nausea,
vomiting and a painful in the left neck. On the first day of treatment, a red rash appeared on the abdomen.
Lips look red, dry and cracked, red in both eyes and red on the tongue. Physical examination showed a
temperature of 37.0, heart rate 102x/minute, conjunctival injection, dry and hyperemic lip mucosa, strawberry
tongue, enlarged submandibular lymph nodes. On laboratory investigation, haemoglobin 13.3, leukocytosis
(20,600) with 81 neutrophil segment, thrombocytosis (442,000). Routine urine examination dark yellow,
slightly cloudy, positive protein 2, positive bilirubin 2, positive urobilinogen 1 , positive ketone 3, positive
blood 2, positive leukocytes (5-10). The patient was treated with IVIG, aspirin, ceftriaxone and paracetamol.
Redness in the abdomen and both eyes disappeared on the 3rd day of treatment, then the child was allowed
to go home on the 5th day of treatment and continued with outpatient control. Conclusion The patient was
diagnosed with Kawasaki disease because diagnostic criteria was fullfilled with 4 additional symptoms that
accompany fever. The patient was treated with Kawasaki disease standard and appear the improvement.

Keywords: fever; Kawasaki disease; vasculitis

KONIKA XVIII Abstract Book 77