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Retrospective analysis of risk factors associated with Kawasaki disease in China
Lihua Bai1, Tienan Feng1,2, Lifang Yang3
1Department of Pediatrics, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University, Shanghai 200123, China.
Insights
Kawasaki Disease (KD) can lead to coronary artery lesions (CAL). Incomplete KD presents differently than typical KD, with specific risk factors like hepatomegaly increasing CAL incidence.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki Disease (KD) is a leading cause of acquired heart disease in children.
- Early intervention for coronary artery lesions (CAL) in KD is crucial.
- Distinguishing between typical and incomplete KD is important for management.
Purpose of the Study:
- To analyze the clinical characteristics of typical and incomplete Kawasaki Disease (KD) cases.
- To identify risk factors associated with coronary artery lesion (CAL) development in KD patients.
Main Methods:
- Retrospective analysis of 383 KD patients (1998-2008) in Northwest and Central China.
- Comparison of clinical manifestations, laboratory assays, and inspection indices between typical and incomplete KD groups.
- Identification of factors correlating with CAL development.
Main Results:
- Incomplete KD accounted for 28.5% of cases and showed distinct clinical features compared to typical KD.
- Certain symptoms like malaise, fatigue, and liver incidence were higher in incomplete KD.
- Elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and hepatomegaly were associated with increased CAL risk.
Conclusions:
- Differential clinical characteristics exist between incomplete and typical Kawasaki Disease.
- Hepatomegaly, elevated CRP and ESR, and IVIG ineffectiveness are identified as high-risk factors for CAL development in KD.
Abstract:
In order to provide early intervention for coronary artery lesion (CAL) caused by Kawasaki Disease (KD), we analyzed clinical characteristics of typical and incomplete KD cases from 1998 to 2008 in Northwest and Central China. A total of 383 patients included 298 cases of typical KD and 85 cases of incomplete KD. The morbidity of incomplete KD was 28.5%, a percentage significantly lower than that of typical KD. The occurrence of bulbar conjunctiva congestion, erythra, crissum red, film-like decrustation, lip red, rhagades, raspberry tongue, bilateral toe-end decrustation, limb sclerosis, cervical lymph nodes enlargement, agitation and irritability in incomplete KD group was lower than that in the group of typical KD (p < 0.05); however, the occurrence of unilateral toe-end decrustation, scar reappearance erythema, malaise, fatigue, liver incidence was significant higher in incomplete KD group (p < 0.05). Based on lab assays and inspection index comparisons, the incomplete KD cases whose C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly increased, had significantly higher reduction in blood platelet (PLT). Interestingly, the KD patients with CPR higher than 30 mg/L, ESR higher than 40 mm/h, hepatomegaly and IVIG ineffectiveness, had higher incidence of CAL development. Altogether, our data have indicated differential clinical characteristics between incomplete KD and typical KD, and have identified several high risk factors of KD for CAL, such as hepatomegaly.
