Title:Clinical Characteristics of Kawasaki Disease in Children with Different Age
Groups: A Literature Review and Retrospective Study
Volume: 29
Issue: 19
Author(s): Baoying Huang, Weiping Tan*, Shan Liao and Wei Jiang
Affiliation:
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
Keywords:
Kawasaki syndrome, children, clinical features, diagnostic criteria, coronary artery injury, glucocorticoids.
Abstract:
Background and Objective: Kawasaki disease (KD) is an acute self-limiting systemic vascular disease
commonly observed in children less than 5 years of age. The present study comparatively assesses the clinical
characteristics of children diagnosed with KD in different age groups. Furthermore, a comprehensive literature
review on the clinical features and diagnostic guidelines of KD is performed.
Methods: This was a retrospective study conducted on the data of KD children admitted to the Sun Yat-Sen Memorial
Hospital, Guangzhou, China, from January 2016 to December 2018. The children were divided into 3
age groups, including children < 1 year of age (group A, n = 66), 1-5 years of age (group B, n = 74), and children
> 5 years of age (group C, n = 14). Complete clinical evaluation, hematological, and cardiovascular assessments
were conducted and compared between the three groups.
Results: The time of diagnosis, hemoglobin, and neutrophil ratio of children in group A were significantly lower
than the other two groups (p < 0.05), while the platelet count was significantly higher (p < 0.05). The proportion
of incomplete KD (iKD) was the greatest in group A (40.9%), while the proportion of children with increased
coronary Z value and aseptic meningitis was greater than that in group B (p < 0.0167). Group A
showed less patients with KD shock syndrome (KDSS) than the other two groups (p < 0.05). Group B showed
the greatest number of patients with arthralgia compared to the other two groups (p < 0.05). Three groups
showed no significant difference to intravenous immunoglobulin (IVIG) therapy (p > 0.05).
Conclusion: The younger the age of KD onset, the more atypical the conditions are, with a greater risk of affecting
other systems and a higher incidences of coronary artery disease. An early treatment with glucocorticoids
might be helpful in older children and those with a greater high-risk KD warning score to prevent coronary injury.
