TY - JOUR
T1 - Incomplete Kawasaki disease in patients younger than 1 year of age
T2 - A possible inherent risk factor
AU - Yeo, Yunku
AU - Kim, Tae Yeon
AU - Ha, Kee Soo
AU - Jang, Gi Young
AU - Lee, Jung Hwa
AU - Lee, Kwang Chul
AU - Son, Chang Sung
AU - Lee, Joo Won
PY - 2009/2
Y1 - 2009/2
N2 - Kawasaki disease (KD) patients younger than 1 year of age are at especially high risk of developing coronary artery abnormalities (CAA). To define the clinical characteristics of this group, as well as the risk factors predisposing them to CAA, we reviewed the medical records of 136 KD patients younger than 1 year of age who were treated at the Korea University Medical Center from January 2001 to July 2006. Of these patients, 16 developed CAA (11.8%). The CAA(+) group had a longer duration of total fever than the CAA(-) group (9.1±3.7 days vs. 6.3±2.0 days, p=0.011), but did not differ in the duration of pre- and post-intravenous gamma-globulin (IVGG) fever. The CAA(+) group had fewer diagnostic symptoms than the CAA(-) group (2.7±1.1 vs. 4.3±1.2, p<0.001). Of the hematological findings, the CAA(+) group only differed from the CAA(-) group in having significantly higher total white blood cell (19.2±6.0 vs. 14.7±4.7 K/mm3, p=0.007) and platelet (462.9±101.0 vs. 383.6±121.1 K/mm3, p=0.014) levels. Multivariable logistic regression analysis showed that the only factors which were significantly associated with the development of CAA were the total number of symptoms (OR=0.493, 95% CI=0.293-0.829, p=0.007) and the duration of total fever (OR=1.405, 95% CI=1.092-1.808, p=0.008). Conclusively, incomplete clinical manifestations and a longer duration of total fever are significantly associated with the development of CAA in KD patients younger than 1 year of age. Therefore, these patients should be monitored for incomplete KD, especially if unexplained fever continues, and treatment to shorten the duration of total fever should be initiated.
AB - Kawasaki disease (KD) patients younger than 1 year of age are at especially high risk of developing coronary artery abnormalities (CAA). To define the clinical characteristics of this group, as well as the risk factors predisposing them to CAA, we reviewed the medical records of 136 KD patients younger than 1 year of age who were treated at the Korea University Medical Center from January 2001 to July 2006. Of these patients, 16 developed CAA (11.8%). The CAA(+) group had a longer duration of total fever than the CAA(-) group (9.1±3.7 days vs. 6.3±2.0 days, p=0.011), but did not differ in the duration of pre- and post-intravenous gamma-globulin (IVGG) fever. The CAA(+) group had fewer diagnostic symptoms than the CAA(-) group (2.7±1.1 vs. 4.3±1.2, p<0.001). Of the hematological findings, the CAA(+) group only differed from the CAA(-) group in having significantly higher total white blood cell (19.2±6.0 vs. 14.7±4.7 K/mm3, p=0.007) and platelet (462.9±101.0 vs. 383.6±121.1 K/mm3, p=0.014) levels. Multivariable logistic regression analysis showed that the only factors which were significantly associated with the development of CAA were the total number of symptoms (OR=0.493, 95% CI=0.293-0.829, p=0.007) and the duration of total fever (OR=1.405, 95% CI=1.092-1.808, p=0.008). Conclusively, incomplete clinical manifestations and a longer duration of total fever are significantly associated with the development of CAA in KD patients younger than 1 year of age. Therefore, these patients should be monitored for incomplete KD, especially if unexplained fever continues, and treatment to shorten the duration of total fever should be initiated.
KW - Coronary abnormalities
KW - Incomplete manifestation
KW - Infants
KW - Kawasaki disease
UR - http://www.scopus.com/inward/record.url?scp=58149098201&partnerID=8YFLogxK
U2 - 10.1007/s00431-008-0722-1
DO - 10.1007/s00431-008-0722-1
M3 - Article
C2 - 18478263
AN - SCOPUS:58149098201
SN - 0340-6199
VL - 168
SP - 157
EP - 162
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 2
ER -