Article Text

PDF
THU0494 Clinical features of children with kawasaki disease in different age groups in southwest china
  1. L Shi1,
  2. J Li1,
  3. D Qie2,
  4. L Qiao2
  1. 1Peking University International Hospital, Beijing
  2. 2West China Second University Hospital, Chengdu, China

Abstract

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.

References

  1. Kowalczyk M,Turska-Kmiec A,Ziolkowska L,et al. [Symptoms, diagnosis and characteristic abnormalities in the coronary arteries in Kawasaki disease in children]. Med Wieku Rozwoj, 2010. 14(4):344–349.

  2. Burns JC,Shike H,Gordon JB,et al. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol, 1996. 28(1):253–257.

  3. Newburger JW,Takahashi M,Gerber MA,et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation, 2004. 110(17):2747–2771.DOI: 10.1161/01.CIR.0000145143.19711.78.

References

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

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.