Clinical features of children with Kawasaki disease aged over 5 years
TIAN Fang, ZHANG Jing, XIAO Lan
Children's Hospital of Chongqing Medical University/National Demonstration Base of Standardized Training Base for Resident Physicians/Ministry of Education Key Laboratory of Child Development and Disorders/Key Laboratory of Pediatrics in Chongqing/Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
Abstract Objective To study the clinical and laboratory features of children with Kawasaki disease (KD) aged > 5 years. Methods A retrospective analysis was performed for the clinical data of 250 elderly children (aged > 5 years) who were diagnosed with KD or incomplete KD (divided into 5-9 years and > 9 years groups) and 266 KD children aged 1-5 years. Clinical and laboratory features were compared between groups. Results The > 9 years group had the lowest incidence rates of hand and foot swelling and fingertip or perianal desquamation (P < 0.05). The 5-9 years group had the highest incidence rate of neck lymph node enlargement (P < 0.05). The > 9 years group had the longest course of fever (P < 0.05). There were no significant differences among the three groups in the incidence rates of rash, bulbar conjunctival hyperaemia and the change in lips, the proportion of children with incomplete KD, and the proportion of children with no response to intravenous immunoglobulin (IVIG). The > 9 years group had the lowest platelet count and albumin (P < 0.05). The 5-9 years group had the highest percentage of neutrophils (P < 0.05). There were no significant differences among the three groups in white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and alanine aminotransferase (P > 0.05). As for the degree of CAL, the 1-5 years group had the highest incidence of mild coronary dilation, and the > 9 years group had the highest incidence rate of moderate coronary aneurysm (P < 0.05). There was no significant difference in the incidence rate of large coronary aneurysm among the three groups (P > 0.05). Conclusions KD children aged > 5 years have atypical clinical manifestations, with a high incidence rate of neck lymph node enlargement, a high percentage of neutrophils, and a low level of albumin and platelet. The risk of moderate coronary aneurysm increases with age.
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