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Features of Kawasaki disease at the extremes of age
Author(s) -
Lee KyungYil,
Hong JaHyun,
Han JiWhan,
Lee JoonSung,
Lee ByungChurl,
Burgner David
Publication year - 2006
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2006.00898.x
Subject(s) - medicine , leukocytosis , kawasaki disease , thrombocytosis , group b , group a , cervical lymphadenopathy , pediatrics , gastroenterology , disease , artery , platelet
Aim: The diagnosis of Kawasaki disease (KD) in those outside the typical age range (6 months−4 years) is often delayed, potentially worsening prognosis. The features of KD in children ≤6 months and ≥5 years were compared with those presenting within the more typical age distribution. Methods: Korean children with complete diagnostic criteria for KD were grouped according to their age at presentation: Group A (≤6 months), Group B (7 months−4 years) and Group C (≥5 years). The clinical features, laboratory findings and outcome in each group were compared. Results: Of 136 children presenting to a single centre between 1999 and 2003, 10 children were in Group A, 114 in Group B and 12 in Group C. The mean total fever duration was 8 days in Group C and 6.2 days in Group A ( P = 0.03). All children in Group C had cervical lymphadenopathy, compared with 50% of Group A and 64% of Group B ( P = 0.01). Coronary artery lesions were commoner in older children (Group C, 42%) compared with Group B (17%, P = 0.05). All children had an equivalent leukocytosis, but Group C had significantly higher neutrophil counts ( P = 0.001). Group A had significantly lower mean haemoglobin ( P = 0.003) and total protein ( P = 0.002) at presentation and a more marked thrombocytosis 1 week after intravenous immunoglobulin therapy ( P < 0.05). Conclusion: The clinical and laboratory phenotype of KD varies with age. Older children may have a more marked inflammatory response and worse outcome. Younger children who are treated appropriately may not have a chance to higher risk of coronary artery lesions.