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Clinical manifestations of Kawasaki disease in different age groups: retrospective data from Southwest China
Lianjie Shi1,2, Jianhong Li3, Di Qie2
1Department of Rheumatology and Immunology, Peking University International Hospital, Beijing, 102206, China.
Insights
Kawasaki disease (KD) presents differently in infants, with common symptoms like cough and diarrhea but fewer classic signs. Early recognition of these varied signs in infants is crucial for timely KD treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Rheumatology
Background:
- Kawasaki disease (KD) is a critical pediatric illness.
- Clinical presentations of KD can vary significantly with age.
- Timely diagnosis and treatment are essential to prevent coronary artery abnormalities.
Purpose of the Study:
- To investigate the age-specific clinical manifestations and laboratory findings in children with Kawasaki disease.
- To improve early recognition and timely treatment of KD across different pediatric age groups.
Main Methods:
- Retrospective analysis of clinical data from 213 children diagnosed with KD.
- Patients were categorized into three age groups: infants, toddlers, and preschool-aged children.
- Statistical comparison using Chi-square and one-way ANOVA analyses.
Main Results:
- Infants with KD frequently exhibited cough and diarrhea, with less common lymphadenopathy and rash.
- Elevated platelet counts were more prevalent in the infant group.
- Toddlers showed a higher incidence of sterile pyuria, while infants under one year had less proteinuria and fewer positive urine ketones.
Conclusions:
- Infants under one year with KD often present with respiratory, gastrointestinal, and urinary symptoms, including sterile pyuria.
- These atypical presentations in infants necessitate increased clinical suspicion for KD.
- Attention to these varied signs aids in earlier diagnosis and treatment, particularly for incomplete KD presentations.
Objectives:
The aim of the present study is to identify the clinical manifestations and laboratory findings of children with Kawasaki disease (KD) in different age groups and to recognize and treat KD in a timely manner.
Methods:
A total of 213 children with KD were divided into the following age groups: (1) infants, (2) toddlers, and (3) preschool age. Retrospective analysis of clinical data was performed among the groups. Categorical data were statistically compared by Chi-square analysis, and measurement data were compared using one-way ANOVA analysis.
Results:
Our study showed that (1) cough (40.5%), diarrhea (16.9%), and vomiting (8.5%) were also very common in KD patients. (2) Patients in the infant group more commonly developed cough and diarrhea, but were less frequently documented with lymphadenopathy and skin rash. (3) Elevation of platelets was more common in the infant group. When urine tests were compared among the three groups, the toddler group had a higher proportion of sterile pyuria, and infants younger than 1 year old had a lower proportion of proteinuria and positive urine ketones.
Conclusion:
Cough, diarrhea, vomiting, and sterile pyuria were very common in infant KD patients less than 1 year old. They should be noted in patients with suspected KD for earlier diagnosis and timely treatments. Key Points • Patients with Kawasaki disease (KD) in different age groups showed different clinical manifestations and laboratory findings. • Cough, diarrhea, vomiting, and sterile pyuria were very common in infant KD patients less than 1 year old. • Paying more attentions to respiratory, gastrointestinal, and urinary manifestations or abnormalities might be helpful for earlier diagnosis of KD, especially incomplete KD, though they were not list in the diagnostic criteria.
