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An observational study on peripheral blood eosinophilia in incomplete Kawasaki disease
Taliha Öner1, Murat Muhtar Yılmazer, Barış Güven
1Clinic of Pediatric Cardiology, İzmir Dr. Behçet Uz Children's Hospital, İzmir-Turkey.
Insights
Peripheral blood eosinophilia (PBE) is significantly higher in incomplete Kawasaki disease (iKD) patients compared to controls. This finding may aid in diagnosing iKD when clinical signs are suggestive.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is an acute febrile illness affecting young children.
- Incomplete Kawasaki disease (iKD) presents with fewer than the typical diagnostic criteria, making diagnosis challenging.
- Peripheral blood eosinophilia (PBE) is a potential indicator in various inflammatory conditions.
Purpose of the Study:
- To investigate the prevalence and significance of peripheral blood eosinophilia (PBE) in the acute phase of incomplete Kawasaki disease (iKD).
- To compare PBE levels in iKD patients with those in complete Kawasaki disease (cKD) and healthy controls.
Main Methods:
- Retrospective analysis of 24 iKD patients and 25 cKD patients diagnosed between 2004-2010.
- Eosinophil counts and rates were determined from complete blood counts before IVIG treatment.
- Comparison with 30 febrile age-matched controls and 30 congenital heart disease controls using Kruskal-Wallis test.
Main Results:
- Patients with iKD showed significantly higher rates of PBE compared to both control groups (p<0.001).
- Eosinophil counts and rates in iKD patients were not significantly different from those with cKD (p>0.05).
- Control groups had significantly lower eosinophil counts and rates than both iKD and cKD groups.
Conclusions:
- Peripheral blood eosinophilia is a notable finding in patients with incomplete Kawasaki disease.
- Elevated eosinophil levels in iKD patients, when compared to controls, may serve as a supportive diagnostic marker.
- Unexplained eosinophilia can be a valuable clue for diagnosing iKD, especially when clinical indicators are present.
Objective:
To investigate the peripheral blood eosinophilia (PBE) in the acute stage of incomplete Kawasaki disease (iKD).
Methods:
Twenty-four patients with iKD (median age; 31.5 months, range; 7-88 months) and 25 with complete Kawasaki disease (cKD) (median age; 37 months, range; 9-140 months) were evaluated between 2004 and 2010 from İzmir Dr. Behçet Uz Children's Hospital records retrospectively. We determined the eosinophil counts and rates from the complete blood count in two study groups before the IVIG treatment and 30 febrile age-matched controls and 30 control cases with congenital heart disease (control Group 1 and 2 respectively). Kruskal-Wallis test was performed in detecting the differences of eosinophil rates and counts between four subgroups.
Results:
In iKD group, the mean value of eosinophil rates and median value of eosinophil counts were 4.39±2.5% and 377 cells/mm(3), respectively, which did not significantly different with cKD group (mean eosinophil rates; 5.47±4.8% and median eosinophil counts 525 cells/mm(3)) (p>0.05). The median values of eosinophil cell counts and mean value of eosinophil rates were 220 cell/mm(3) and 2.83±2.65% in the control group 1 and 165 cell/mm(3) and 1.63±1.43% in the control Group 2 respectively, which were statistically significant lower compared to both study groups (p< 0.001).
Conclusion:
The rate of PBE was found significantly higher in iKD patients compared to the controls. Since the diagnosis of iKD is difficult, unexplained eosinophilia may be helpful in the presence of suggestive clinical findings of KD.
