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The Impact of Onset Age on Eosinophils in Kawasaki Disease
Yu-Jhen Chen1,2, Mindy Ming-Huey Guo1,2, Ling-Sai Chang1,2
1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Insights
Kawasaki disease (KD) in young children is linked to eosinophil levels. Higher eosinophil counts in KD patients may increase the risk of coronary artery lesions, especially in infants under six months.
Area of Science:
- Pediatrics
- Immunology
- Allergy
Background:
- Kawasaki disease (KD) predominantly affects children under five.
- Eosinophilia in KD patients may correlate with future allergic disease development.
- Investigating the impact of onset age on eosinophil levels in KD is crucial.
Purpose of the Study:
- To compare age-adjusted eosinophil Z-scores in Kawasaki disease patients.
- To evaluate the influence of patient age at onset on eosinophil counts.
- To assess the relationship between eosinophil levels and coronary artery lesions (CALs).
Main Methods:
- Analysis of laboratory data from 398 Kawasaki disease patients.
- Categorization of patients into seven age subgroups.
- Comparison of age-adjusted eosinophil Z-scores across different disease phases.
Main Results:
- Significant differences in absolute eosinophil counts were observed post-intravenous immunoglobulin (IVIG) and throughout KD, adjusted for age.
- Persistent elevation of age-adjusted eosinophil Z-scores (Z-eosinophil) was noted, particularly in infants under six months.
- Higher Z-eosinophil levels correlated with an increased risk of CALs, while lower levels correlated with a decreased risk.
Conclusions:
- Clinicians should monitor for allergic diseases during KD follow-up, especially in infants under six months.
- Eosinophil count serves as a critical indicator in managing Kawasaki disease.
- Age-adjusted eosinophil levels offer insights into KD prognosis and potential complications.
Abstract:
(1) Background: Kawasaki disease (KD) mainly affects children under the age of 5 years and eosinophilia in KD patients might be associated with the development of allergic diseases. We compared the age-adjusted Z-score (Z) of eosinophils and aimed to evaluate the impact of onset age on eosinophils in KD patients. (2) Methods: We divided 398 KD patients into seven age subgroups. Laboratory data and the age-adjusted Z-score of eosinophils during the phases of Kawasaki disease were analyzed. (3) Results: The absolute eosinophil count among all age groups showed significant differences in the post-intravenous immunoglobulin (IVIG) phase and throughout the course of KD with Z-score adjusted for age. Further analysis showed persistent elevation of the age-adjusted Z-score of eosinophils (Z-eosinophil) especially in the under six-month-old age subgroup. In addition, we divided the Z-eosinophil into two groups to find the relationship with coronary artery lesions (CALs). Patients with a higher eosinophil count than average age values had a higher risk of developing CALs, while those with a lower eosinophil count than average age values had a lower risk of having CALs. (4) Conclusions: These findings may provide information to clinicians to pay attention to allergic diseases during the follow-up of KD, especially for children who are younger than 6 months old at the onset of KD, and eosinophil count could be a crucial focus in KD.
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