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Significance of Differential Characteristics in Infantile Kawasaki Disease

Ji Hee Kwak1, JungHwa Lee2, Kee Soo Ha3

  • 1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Korean Circulation Journal
|May 11, 2019
PubMed

Insights

Kawasaki disease (KD) laboratory values differ significantly between infants and older children. Age-adjusted hemoglobin and C-reactive protein levels can help distinguish KD in infants from simple febrile illness.

Area of Science:

  • Pediatric Immunology
  • Hematology
  • Clinical Laboratory Science

Background:

  • Kawasaki disease (KD) exhibits age-specific immunological variations.
  • Previous studies have not specifically compared laboratory values between infant and non-infant KD patients.
  • Understanding these differences is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To compare age-adjusted laboratory values, specifically white and red blood cell counts, between infants and non-infants diagnosed with Kawasaki disease.
  • To identify laboratory markers that can aid in differentiating KD in infants.

Main Methods:

  • Retrospective analysis of 192 infants and 667 non-infants with KD from 2003-2015.
  • Determination of age-unadjusted raw values (R) and age-adjusted Z-values (Z) for blood cell counts.
  • Comparison of laboratory values between infant and non-infant KD cohorts.

Main Results:

  • Infants with KD showed distinct patterns including lymphopenia, eosinophilia, low neutrophil ratios, anemia, thrombocytosis, and reduced erythrocyte sedimentation rates compared to non-infants.
  • Pre-intravenous immunoglobulin (IVIG) Z-hemoglobin <-0.01 effectively predicted KD in all patients (AUC, 0.914).
  • Pre-IVIG C-reactive protein (CRP) >40 mg/L differentiated KD infants from febrile controls (AUC, 0.811).

Conclusions:

  • Laboratory findings provide a basis for differentiating between infant and non-infant Kawasaki disease.
  • These hematological differences enhance the understanding of KD pathophysiology across age groups.
  • Pre-IVIG Z-hemoglobin and CRP are valuable for distinguishing incomplete KD in infants from simple febrile illnesses.
Abstract

Keywords:
Differential leukocyte countHemoglobinInfantKawasaki disease

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