Affects of "age at diagnosis" on coronary artery lesions in patients with incomplete kawasaki disease.
OBJECTIVE
Diagnosis of Kawasaki disease (KD) is based on 5 clinical features. Incomplete KD (IKD), which has fewer features, is more common in infants and older children, in whom the rate of coronary artery aneurysms is paradoxically higher. We conducted this study to evaluate risk factors associated with age-at-diagnosis on coronary arterial lesions (CAL) in patients with IKD.


METHODS
Retrospective data from 396 patients with KD in a single center were collected from January 2003 to July 2007. Patients were grouped according to their age at diagnosis; Group A (<1 year of age), Group B (1</=age<5 years of age), and Group C (>/=5 years of age).


RESULTS
Among a total of 396 patients with KD, 87 (22.0%) were in Group A, 246 (62.1%) in Group B, and 63 (15.9%) in Group C. In groups A and C, lag times for starting intravenous immunoglobulin (IVIG) were longer than in Group B. There were no differences in the incidence of IKD, late CAL, or rates of IVIG retreatment among the three groups. Among 174 patients with IKD, there were no age-related differences in late CAL incidence or IVIG retreatment. Compared with typical KD, duration of fever and lag times to start IVIG were longer, and the rate of IVIG retreatment was higher in IKD, but there was no difference in the risk of CAL between typical KD and IKD.


CONCLUSIONS
In the management of KD, especially the incomplete type, age-associated factors appear not to be significant for predicting the development of CAL.
Cho
Min A
MA
Division of Pediatric Cardiology, Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
Choi
Yeon Joo
YJ
Jung
Jo Won
JW