Features of Kawasaki disease at the extremes of age.
OBJECTIVE
The diagnosis of Kawasaki disease (KD) in those outside the typical age range (6 months-4 years) is often delayed, potentially worsening prognosis. The features of KD in children<or=6 months and >or=5 years were compared with those presenting within the more typical age distribution.


METHODS
Korean children with complete diagnostic criteria for KD were grouped according to their age at presentation: Group A (<or=6 months), Group B (7 months-4 years) and Group C (>or=5 years). The clinical features, laboratory findings and outcome in each group were compared.


RESULTS
Of 136 children presenting to a single centre between 1999 and 2003, 10 children were in Group A, 114 in Group B and 12 in Group C. The mean total fever duration was 8 days in Group C and 6.2 days in Group A (P=0.03). All children in Group C had cervical lymphadenopathy, compared with 50% of Group A and 64% of Group B (P=0.01). Coronary artery lesions were commoner in older children (Group C, 42%) compared with Group B (17%, P=0.05). All children had an equivalent leukocytosis, but Group C had significantly higher neutrophil counts (P=0.001). Group A had significantly lower mean haemoglobin (P=0.003) and total protein (P=0.002) at presentation and a more marked thrombocytosis 1 week after intravenous immunoglobulin therapy (P<0.05).


CONCLUSIONS
The clinical and laboratory phenotype of KD varies with age. Older children may have a more marked inflammatory response and worse outcome. Younger children who are treated appropriately may not have a chance to higher risk of coronary artery lesions.
Lee
Kyung-Yil
KY
Department of Paediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. leekyungyil@catholic.ac.kr
Hong
Ja-Hyun
JH
Han
Ji-Whan
JW
Lee
Joon-Sung
JS
Lee
Byung-Churl
BC
Burgner
David
D
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies