Abstract 143: Clinical Consideration of Kawasaki Disease Development in Younger and Older Children
Background: Kawasaki disease (KD) is an acute febrile illness of childhood. Most KD patients are children aged from 6 months to 4 years, although a small number of cases occur in children less than 6 months or over 5 years of age. KD symptoms are not easily observed in younger and older children, and so it is necessary to understand how the features of KD change with age.
Objective: This study aimed to evaluate the clinical features of KD in children less than 6 months and greater than 5 years of age in our hospital.
Methods: Patients diagnosed between October 2006 and September 2013 were divided into 2 groups: group A included 19 infants less than 6 months old and group B included 222 children who were more than 6 months old (1). On the other hand, patients were divided into another 2 groups: group C which included 219 children less than 5 years old and group D which included 29 children who were more than 5 years old (2). The features and symptoms of KD were compared between the groups; in particular, white blood cell counts, neutrophil ratios, platelet counts, total bilirubin, aspartate transaminase, alanine transaminase, sodium, C-reactive protein, fibrinogen, D-dimer, and intravenous immunoglobulin unresponsive scores were compared.
Results: (1) Few infants less than 6 months old had changes in their extremities or cervical lymph node swelling; most of the infants less than 6 months old had incomplete KD. The neutrophil ratio before treatment tended to be significantly lower in infants less than 6 months old. (2) Most of the children over 5 years old had erythema, but few had significant cervical lymph node swelling. The neutrophil ratio before treatment tended to be significantly higher in infants over 5 years old.
Discussion: The symptoms of KD are not easily observed in infants less than 6 months old, and so KD diagnosis can be difficult. KD in children over 5 years old is sometimes diagnosed as pyogenic cervical lymphadenitis, and these patients sometimes have to wait a long time to be diagnosed with KD. It is important to carefully observe the clinical progress of young infants with a continuing high fever and children diagnosed with pyogenic cervical lymphadenitis.
Author Disclosures: K. Sakurai: None.
- © 2015 by American Heart Association, Inc.