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Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months

Yunjia Tang1, Xuan Li1, Lei Cao1

  • 1Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China.

Frontiers in Pediatrics
|September 14, 2020
PubMed

Insights

Infantile Kawasaki disease (KD) under 6 months presents unique characteristics, including higher rates of incomplete KD (iKD) and coronary artery lesions. Laboratory markers can help identify iKD in infants compared to urinary tract infection or adenovirus infection.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness, particularly challenging in infants under 6 months.
  • Identifying incomplete KD (iKD) in this age group is crucial for timely intervention and preventing complications.
  • Understanding the specific clinical and laboratory features of infantile KD is essential for accurate diagnosis.

Purpose of the Study:

  • To characterize Kawasaki disease (KD) in patients under 6 months of age.
  • To identify potential indicators for incomplete KD (iKD) in infants.
  • To compare laboratory findings of iKD in infants with urinary tract infection (UTI) and adenovirus (ADV) infections.

Main Methods:

  • Retrospective analysis of medical records of 1,872 KD patients.
  • Focus on 194 infantile KD patients (< 6 months) and comparison with older KD patients.
  • Age and gender-matched controls of 50 UTI and 50 ADV-infected infants with high fever.

Main Results:

  • Infantile KD patients (< 6 months) showed higher iKD rates (37.1%) compared to older patients (29.4%).
  • Infants had shorter fever duration before IVIG but higher rates of IVIG resistance and coronary artery lesions.
  • Distinct laboratory profiles in infants included higher platelet (PLT) and C-reactive protein (CRP), lower hemoglobin (Hb), neutrophils (N%), albumin, and serum sodium.
  • Specific thresholds for Hb, CRP, N%, and PLT differentiated iKD from ADV infection, while N% and albumin differentiated iKD from UTI.

Conclusions:

  • Infantile KD patients (< 6 months) exhibit unique clinical and laboratory characteristics.
  • Laboratory variables like Hb, CRP, N%, PLT, and albumin can serve as valuable indicators for diagnosing iKD in infants, especially when compared to UTI and ADV infections.

Keywords:
Kawasaki diseaseadenovirus infectioncharacteristicsindicationsinfantsurinary tract infection

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