Korean Circ J.  2015 Nov;45(6):510-515. 10.4070/kcj.2015.45.6.510.

Early Detection of Kawasaki Disease in Infants

• Kang JH
• Hong SJ
• Seo IA
• Kwak MH
• Cho SM
• Kim DK
• Choi SM
• Lee DS

• KMID: 2223790
• DOI: http://doi.org/10.4070/kcj.2015.45.6.510

Abstract

BACKGROUND AND OBJECTIVES
This study aimed to investigate the clinical characteristics of infantile Kawasaki disease (KD), and to evaluate early diagnostic features of KD in febrile infants.
SUBJECTS AND METHODS
We retrospectively reviewed the medical records of 64 KD patients from January 2010 to October 2014. There was an analysis of the clinical, laboratory data of the infants versus children groups. Furthermore, the clinical and laboratory data of infantile KD patients were compared with 16 infants who were admitted for other acute febrile diseases.
RESULTS
A total of 64 patients with KD were identified; 20 (31.3%) were infants; 44 (68.8%) were >1 year old children. Incomplete KD was much more common in infants (n=13, 65.0%) than in children group (n=14, 31.8%) (p=0.013). The infants were characterized by significantly higher rates of inflammatory changes at the Bacille Calmett-Guerin (BCG) inoculation site (p<0.001), but lower rates of changes in the extremities (p=0.029) and cervical lymphadenopathy (p=0.006). The serum levels of platelet after 1 week (p=0.005), C-reactive protein (p=0.038), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (p=0.026) were all significantly higher in the infants group. Comparing the infants with KD versus the other acute febrile diseases, there were significantly higher serum levels of erythrocyte sedimentation rate (p=0.002), C-reactive protein (p=0.046) and NT-proBNP (p=0.001) for the infants with KD group.
CONCLUSION
BCGitis and higher levels of NT-proBNP can be helpful for early diagnosis of the incomplete KD in infants, and may be a good predictor of KD in acute febrile infants, when combined with other acute phase reactants.

Keyword

Early detection of disease; Infants; Kawasaki disease

MeSH Terms

Acute-Phase Proteins
Blood Platelets
Blood Sedimentation
C-Reactive Protein
Child
Early Diagnosis
Extremities
Humans
Infant*
Lymphatic Diseases
Medical Records
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies
Acute-Phase Proteins
C-Reactive Protein

Figure

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  Fig. 1 Erythema and induration at the Bacille Calmette-Guérin inoculation site.

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