A comparative study of pediatric patients with Complete vs. Incomplete Kawasaki Disease in a tertiary Hospital: An eleven year review

Introduction@#Kawasaki disease (KD) is the leading cause of acquired heart disease in childhood, but its diagnosis remains challenging since a significant number of cases do not meet the diagnostic criteria (Incomplete KD). This may delay the diagnosis and initiation of treatment, and increase the risk of morbidity from coronary artery complications.@*Objectives@#This study compared the clinical profile and treatment outcomes of children with complete and incomplete KD. @*Methods@#This is a cross-sectional, retrospective study of pediatric patients diagnosed with KD and admitted in a tertiary hospital from January 1, 2010 to December 31, 2020. Demographics, clinical manifestations, laboratories, 2D echocardiography (2DE) findings and treatment outcomes were obtained by review of medical records and analyzed using descriptive statistics. @*Results@#Among 135 patients studied, 71% were classified as Incomplete Kawasaki Disease. Majority (89%) were children more than 1 year old and predominantly male (55%). Five classic features, other than fever, were more frequent in complete KD – bilateral bulbar conjunctivitis, mucosal changes in the lip and oral cavity, polymorphous exanthem, changes in extremities, and cervical lymphadenopathy. Fever (100%), conjunctivitis (100%), rashes (97%) and oral changes (90%) were the most common findings in complete KD, while fever (100%), rashes (56%), conjunctivitis (46%) and oral changes (35%) were noted in incomplete KD. Higher CRP (167 mg/L vs. 100 mg/L) and lower albumin levels (30 g/L vs. 38 g/L) were seen in complete KD. Coronary artery dilatation (56% vs. 48%) was frequently detected in both complete and incomplete KD. Majority (96%) of cases received only one dose of IVIG and 4% needed additional treatment with methylprednisone. @*Conclusion@#The five principal features of KD other than fever, elevated CRP and lower albumin levels were significantly more common in complete cases. No significant differences in the demographics and 2DE findings of children with complete and incomplete KD were observed.

Epidemiology of Kawasaki disease in infants 3 months of age and younger / 소아과

PURPOSE: This study investigated the epidemiology of Kawasaki disease (KD) in infants 3-month-old. RESULTS: The 609 KD patients 2- and 3-months-old. The ratio of males to females was 1.72:1. The incidence of coronary artery (CA) dilatation (19.9% vs. 18.7%) and CA aneurysms (3.4% vs. 2.6%) detected by echocardiography did not differ significantly between patients with KD younger and older than 3-month-old. CONCLUSION: Compared with the data for the KD patients >3-month-old, the data for the 609 patients < or =3-month-old did not show a significantly higher incidence of CA dilatation or CA aneurysms.

Coronary Risk Factors in Kawasaki Disease

PURPOSE: Kawasaki disease is an acute febrile vasculitis that may cause coronary artery dilatation after the acute phase. We assessed the risk factors of coronary artery dilatation in patients diagnosed with Kawasaki disease. METHODS: From January 1995 through April 2003, a total of 362 patients with Kawasaki disease were enrolled. After dividing these patients into two groups by presence of coronary artery dilatation, we analyzed and compared the early symptoms and laboratory findings. RESULTS: A total of 362 patients were divided into two groups: Group 1 consisted of 65 patients(18.0%) with coronary artery dilatation, while Group 2 consisted of 297 patients(82.0%) with normal coronary arteries. Group 1 exhibited longer duration of fever during the early symptoms and showed elevated levels of CRP and cardiac Troponin-I(cTnI). WBC count, hemoglobin, hematocrit, platelet count, erythrocyte sedimentation rate, hepatic enzymes, serum albumin, CK-MB, total eosinophil count, age and sex were not significantly different between the two groups. CONCLUSION: As the severity of early inflammatory reaction increased, the risk of coronary artery dilatation increased accordingly. Therefore it is essential to establish a treatment to reduce the early inflammatory reaction in order to decrease coronary artery complications.