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Early Detection of Kawasaki Disease in Infants
Ji Hae Kang1, Seung Ji Hong1, In Ae Seo1
1Department of Pediatrics, Dongguk University School of Medicine, Gyeongju, Korea.
Insights
Kawasaki disease (KD) in infants often presents as incomplete KD, showing unique symptoms like BCG site inflammation. Higher NT-proBNP levels aid in early diagnosis of KD in febrile infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Infantile Kawasaki disease (KD) presents unique clinical characteristics.
- Incomplete KD is more prevalent in infants compared to older children.
- Early diagnosis of KD in febrile infants is crucial for timely intervention.
Purpose of the Study:
- To investigate the clinical features of Kawasaki disease in infants.
- To identify early diagnostic markers for Kawasaki disease in febrile infants.
Main Methods:
- Retrospective review of 64 Kawasaki disease patients (2010-2014).
- Comparison of clinical and laboratory data between infant and child KD groups.
- Comparison of infantile KD patients with infants having other febrile diseases.
Main Results:
- Infants showed higher rates of Bacille Calmett-Guérin (BCG) site inflammation but lower rates of extremity changes and cervical lymphadenopathy.
- Infants with KD exhibited higher serum platelet counts, C-reactive protein, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels.
- Febrile infants with KD had significantly elevated erythrocyte sedimentation rate, C-reactive protein, and NT-proBNP compared to those with other febrile illnesses.
Conclusions:
- Bacille Calmett-Guérin (BCG) site inflammation (BCGitis) and elevated NT-proBNP are valuable indicators for diagnosing incomplete Kawasaki disease in infants.
- NT-proBNP, combined with other acute phase reactants, may predict Kawasaki disease in febrile infants.
Background And Objectives:
This study aimed to investigate the clinical characteristics of infantile Kawasaki disease (KD), and to evaluate early diagnostic features of KD in febrile infants.
Subjects And Methods:
We retrospectively reviewed the medical records of 64 KD patients from January 2010 to October 2014. There was an analysis of the clinical, laboratory data of the infants versus children groups. Furthermore, the clinical and laboratory data of infantile KD patients were compared with 16 infants who were admitted for other acute febrile diseases.
Results:
A total of 64 patients with KD were identified; 20 (31.3%) were infants; 44 (68.8%) were >1 year old children. Incomplete KD was much more common in infants (n=13, 65.0%) than in children group (n=14, 31.8%) (p=0.013). The infants were characterized by significantly higher rates of inflammatory changes at the Bacille Calmett-Guérin (BCG) inoculation site (p<0.001), but lower rates of changes in the extremities (p=0.029) and cervical lymphadenopathy (p=0.006). The serum levels of platelet after 1 week (p=0.005), C-reactive protein (p=0.038), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (p=0.026) were all significantly higher in the infants group. Comparing the infants with KD versus the other acute febrile diseases, there were significantly higher serum levels of erythrocyte sedimentation rate (p=0.002), C-reactive protein (p=0.046) and NT-proBNP (p=0.001) for the infants with KD group.
Conclusion:
BCGitis and higher levels of NT-proBNP can be helpful for early diagnosis of the incomplete KD in infants, and may be a good predictor of KD in acute febrile infants, when combined with other acute phase reactants.
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