Clinical Analysis and Comparison of Kawasaki Disease between Patients Younger than One Year of Age and Those over One Year of Age

ABSTRACT

PURPOSE: To identify the risk factors for coronary sequelae in Kawasaki disease, we analyzed and compared the clinical features and laboratory findings of Kawasaki disease in patients younger than one year of age with those over one year of age. METHODS: A retrospective chart review was conducted of all children with Kawasaki disease who were admitted to the Catholic University Taejon St. Mary's hospital between March 1992 and December 1997. RESULTS: Of 162 patients with Kawasaki disease, 36 patients(22.2%) were less than one year of age and four(11.1%) of them had coronary artery aneurysms. On the other hand, 126 patients (77.8%) were above 12 months and 15(11.9%) of them developed coronary artery aneurysms. The Kawasaki criteria signs were not significantly prominent(P<0.05) and maximal platelet count was higher in the infant group(P<0.05) but other clinical and laboratory findings were not different between the two groups. Comparative studies revealed that maximal platelet count was higher (P<0.05), and total duration of fever was significantly longer in the patients with coronary aneurysms(19 cases, P<0.001) than those without coronary aneurysms(143 cases). CONCLUSION: We cannot find any significant clinical and laboratory differences including coronary artery involvement in Kawasaki disease between less than one year of age and over one year. The age of onset seems not to be a predictor for the risk of coronary aneurysm. The principal signs of Kawasaki disease can be less prominent in infant. For this reason, early diagnosis utilizing laboratory findings are important, especially in the course of illness with prolonged fever.