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Characteristics of Kawasaki disease in older children

Zhaohua Cai1, Rihan Zuo, Yali Liu

  • 1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.

Clinical Pediatrics
|June 2, 2011
PubMed

Insights

Kawasaki disease (KD) in older children presents unique challenges, often leading to delayed diagnosis and increased risk of coronary artery abnormalities. Early recognition and treatment are crucial for better outcomes in pediatric patients.

Area of Science:

  • Pediatrics
  • Rheumatology
  • Infectious Diseases

Background:

  • Kawasaki disease (KD) is a critical pediatric illness.
  • Understanding KD characteristics in older children is essential for timely diagnosis and management.
  • Previous studies have primarily focused on younger pediatric populations.

Purpose of the Study:

  • To compare Kawasaki disease (KD) clinical features in older children (≥5 years) versus younger children (<5 years).
  • To enhance clinical awareness and knowledge regarding KD presentation in older pediatric patients.

Main Methods:

  • Retrospective review of 113 pediatric patients diagnosed with KD.
  • Data collected from Wuhan Union Hospital between January 2004 and May 2010.
  • Comparison of clinical criteria, fever duration, inflammatory markers (ESR), and treatment outcomes between age groups.

Main Results:

  • Older children (≥5 years) showed longer fever duration and later onset of clinical KD criteria, except cervical lymphadenopathy.
  • A higher incidence of cervical lymphadenopathy (85.0% vs 51.6%) and elevated ESR (85.92 vs 67.27) was observed in older children.
  • The older group had a greater prevalence of requiring additional intravenous immunoglobulin (IVIG) treatment and developing coronary artery abnormalities (60.0% vs 32.2%).

Conclusions:

  • Kawasaki disease (KD) in older children poses diagnostic and therapeutic challenges due to delayed presentation.
  • Older children exhibit a more pronounced inflammatory response and higher likelihood of requiring repeat IVIG treatment.
  • Delayed diagnosis and treatment in older children correlate with an increased prevalence of coronary artery abnormalities.
Abstract

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