Key result
Kawasaki disease under 6 months linked to ~28% more coronary lesions vs older patients.
Why the study?
The characteristics of Kawasaki disease under six months and indications of incomplete KD were not well defined compared with other febrile illnesses in infants.
What are the characteristics of Kawasaki disease in infants under six months, and which laboratory variables can indicate incomplete Kawasaki disease compared to UTI and ADV infection?
Observational (n=1,972)
No
What are the characteristics of Kawasaki disease in infants under six months, and which laboratory variables can indicate incomplete Kawasaki disease compared to UTI and ADV infection?
Absolute Event Rate: 36.1% vs 28.2%
p-value: p=0.022
Specific laboratory thresholds for CRP, neutrophil percentage, platelet count, and albumin can help differentiate incomplete Kawasaki disease from urinary tract and adenovirus infections in infants under six months.
Supports closer coronary surveillance in infants under 6 months; case-control data leaves open prospective validation of age-specific protocols.
Objectives: To explore the characteristics of Kawasaki disease (KD) under six months and to investigate the possible indications of incomplete KD (iKD). Methods: The medical records of KD patients hospitalized in Children’s Hospital of Soochow University from January 2007 to December 2017 were retrospectively reviewed and analyzed. A total of 50 cases of urinary tract infection (UTI) and 50 cases of adenovirus (ADV) -infected patients under six months that were age and gender-matched with the main complaint of high fever were selected as controls. Results: A total of 1872 KD patients were enrolled. Among them, 194 (10.4%) were infantile patients under six months. There were 72 (37.1%) and 494 (29.4%) iKD in patients younger and older than six months, respectively (P 22.7mg/L, N% > 47.4 and PLT > 496 × 109/L were indications of iKD when compared with ADV infection (area under the curve [AUC]: 0.872, 0.939, 0.707 and 0.684, respectively). N% > 51.8 and albumin < 39.0 g/L were indications of iKD when compared with UTI (AUC: 0.627 and 0.832, respectively). Conclusions: Infantile KD patients under six months had their own particularity. Laboratory variables could be good indications of iKD when compared with UTI and ADV infection.
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Tang et al. (2020) conducted an observational in Kawasaki disease (n=1,972). Age under 6 months vs. Age older than 6 months was evaluated on Coronary artery lesions (CAL) (p=0.022). Infants under 6 months with Kawasaki disease had a significantly higher incidence of coronary artery lesions (36.1% vs 28.2%) and IVIG resistance compared to older patients.
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