Background Kawasaki disease (KD) is a systemic vasculitis characterized by acute and prolonged fever. The prevalence of coronary artery abnormality (CAA) is as high as 11%. The young infants usually have the increased risk of CAA, but do not have the typical clinical manefestations of KD.
Objectives To explore clinical features of children with KD in different age groups to improve the prognosis of KD.
Methods A total of 218 children with kawasaki disease were divided into the infants group, the toddlers' group, the pre-school age group and the school age group. Retrospective analysis of clinical data were performed among the groups. Categorical data were compared with each other statistically by Chi-square analysis. Statistical significant was defined as P <0.05. Due to the insufficient cases of school age group and five cases of patients with entire clinical data, the analysis was focused on the other three groups and excluded the five cases in the following statistical analysis.
Results (1) Among the 218 KD patients, the male to female ratio was 1.5:1 and the recurrence rate was 1.8%. Seven cases (3.2%) were diagnosed as atypical KD, and 84 (38.5%) patients accepted intravenous gamma globulin (IVIG) treatment after the sixth day of KD onset. The incidence of IVIG-resistent KD was 8.7% and the rate of coronary dilation was 11.5%. (2) Fever was the most common clinical feature (100%). The bilateral bulbar conjunctiva injection and the change in mucosa of oropharynx were 85.4% and 81.2% respectively. Moreover, cough (40.5%), diarrhea (16.9%) and vomiting (8.5%) were also very common in the present KD patients. (3) Patients from the toddlers' group were more common to develop lymphadenopathy and skin rash (χ2=7.784, P=0.02; χ2=10.794, P=0.005), but were less frequently to be documented with cough and diarrhea (χ2=7.334, P=0.026; χ2=18.447, P=0.000). (4) The incidence of increased platelets was more common in the infants group (χ2=7.552, P=0.023). Comparing with the urine test among three groups, the toddlers' group had a higher incidence of sterile pyuria (χ2=10.653, P=0.005), and infants younger than 12 months old had a lower incidence of proteinuria and positive urine ketone (χ2=15.507, P=0.000; χ2=40.336, P=0.000).
Conclusions The respiratory tract, the digestive and urinary systems are involved commonly in Kawasaki disease, and patients from different age groups showed different clinical features, which should be pay more attention to promote the prognosis.
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Acknowledgements This work was supported by grants from the Natural Science Foundation of China (81501396 to Dr. Lianjie Shi, and 81302554 to Dr. Fanlei Hu).
Disclosure of Interest None declared