TY - JOUR
T1 - Characteristics of Kawasaki disease in infants younger than six months of age
AU - Chang, Feng Yu
AU - Hwang, Betau
AU - Chen, Sue Jean
AU - Lee, Pi Chang
AU - Meng, C. C.Laura
AU - Lu, Jen Her
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/3
Y1 - 2006/3
N2 - Background: Kawasaki disease is the leading cause of acquired heart disease in childhood. However, there are only a few reports in infants younger than 6 months. The objective of this study is to investigate the clinical and laboratory characteristics of Kawasaki disease in infants younger than 6 months. Methods: From 1994 to 2003, 120 patients with Kawasaki disease diagnosed at our institution were included. Group 1 consisted of 20 (17%) patients younger than 6 months, and group 2 consisted of 100 (83%) patients older than 6 months. Clinical manifestations, laboratory results, echocardiographic findings, treatment and outcome were compared between these 2 groups. Results: Clinical manifestations (hydrops of gallbladder: 0% versus 16%, P < 0.001) and laboratory results (white blood cell count 21,740 ± 11,706 versus 11,830 ± 4390/mm3, P < 0.001; hemoglobin 9.98 ± 1.25 versus 10.8 ± 1.37 g/dL, P = 0.015; platelet 483 ± 393 versus 355 ± 138 X 1000/mm3, P = 0.011; triglyceride 138 ± 77.5 versus 107 ± 17 mg/dL, P < 0.001) were different between patients with Kawasaki disease younger and older than 6 months, respectively. Younger infants were more likely to have incomplete presentation (35% versus 12%, P = 0.025), coronary involvement (65% versus 19%, P < 0.001), late intravenous immunoglobulin treatment and relatively poor outcome. Conclusions: Infants younger than 6 months with prolonged unexplained febrile illnesses should be suspected as having Kawasaki disease, despite the incomplete clinical presentation. Because early diagnosis and timely treatment are difficult in younger infants with Kawasaki disease because of delayed and incomplete clinical presentations, echocardiogram becomes an important implement for diagnosis. Early intravenous immunoglobulin treatment is required in view of the highest risk of coronary involvement in them.
AB - Background: Kawasaki disease is the leading cause of acquired heart disease in childhood. However, there are only a few reports in infants younger than 6 months. The objective of this study is to investigate the clinical and laboratory characteristics of Kawasaki disease in infants younger than 6 months. Methods: From 1994 to 2003, 120 patients with Kawasaki disease diagnosed at our institution were included. Group 1 consisted of 20 (17%) patients younger than 6 months, and group 2 consisted of 100 (83%) patients older than 6 months. Clinical manifestations, laboratory results, echocardiographic findings, treatment and outcome were compared between these 2 groups. Results: Clinical manifestations (hydrops of gallbladder: 0% versus 16%, P < 0.001) and laboratory results (white blood cell count 21,740 ± 11,706 versus 11,830 ± 4390/mm3, P < 0.001; hemoglobin 9.98 ± 1.25 versus 10.8 ± 1.37 g/dL, P = 0.015; platelet 483 ± 393 versus 355 ± 138 X 1000/mm3, P = 0.011; triglyceride 138 ± 77.5 versus 107 ± 17 mg/dL, P < 0.001) were different between patients with Kawasaki disease younger and older than 6 months, respectively. Younger infants were more likely to have incomplete presentation (35% versus 12%, P = 0.025), coronary involvement (65% versus 19%, P < 0.001), late intravenous immunoglobulin treatment and relatively poor outcome. Conclusions: Infants younger than 6 months with prolonged unexplained febrile illnesses should be suspected as having Kawasaki disease, despite the incomplete clinical presentation. Because early diagnosis and timely treatment are difficult in younger infants with Kawasaki disease because of delayed and incomplete clinical presentations, echocardiogram becomes an important implement for diagnosis. Early intravenous immunoglobulin treatment is required in view of the highest risk of coronary involvement in them.
KW - Coronary involvement
KW - Infants
KW - Kawasaki disease
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U2 - 10.1097/01.inf.0000202067.50975.90
DO - 10.1097/01.inf.0000202067.50975.90
M3 - Article
C2 - 16511387
AN - SCOPUS:33644926179
SN - 0891-3668
VL - 25
SP - 241
EP - 244
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 3
ER -