Clinical Characteristics of Kawasaki Disease in Infants Younger than 3 Months of Age.
- Author:
Soo Jeong LEE
1
;
So Jung KIM
;
Hae Soon KIM
;
Sejung SOHN
Author Information
1. Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea. sohn@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Kawasaki disease;
BCG;
Infant
- MeSH:
Diagnosis;
Dilatation;
Early Diagnosis;
Echocardiography;
Erythema;
Follow-Up Studies;
Humans;
Immunoglobulins, Intravenous;
Infant*;
Mitral Valve Insufficiency;
Mitral Valve Prolapse;
Mucocutaneous Lymph Node Syndrome*;
Mycobacterium bovis;
Retrospective Studies
- From:Journal of the Korean Pediatric Society
2003;46(6):591-596
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Kawasaki disease(KD) is rare in infants <3 months of age. In this younger group, the diagnosis may be delayed due to lack of most of the clinical criteria, resulting in a high risk of cardiac complications. We examined clinical characteristics in these patients for early recognition and treatment. METHODS: We conducted a retrospective study on the infants with KD aged three months or younger treated at our hospital from January 1998 to July 2002. RESULTS: Of a total of 291 patients treated during the study period, 11(3.8%) were three months old or younger. Of the 11 patients, 10 had atypical presentations. Infants had fewer of the accepted criteria, and the most common findings were fever(100%) and oral mucosal changes(72.7%). Erythema at the site of BCG inoculation was observed in six of the 11 patients(unknown in the remaining five). This feature proved a definite diagnostic clue in two patients in whom cardiac omplications developed in the subacute phase. Cardiac complications were found in six patients(54.5%) : three had coronary dilatation, two had coronary wall irregularity, and one had mitral valve prolapse with regurgitation. Defervescence occurred within 1.1+/-0.3 day in 10 of the 11 patients treated with intravenous immunoglobulin(IVIG) and one was given a second course of IVIG. Echocardiographic abnormality persisted in only one patient with mitral regurgitation at the 6-month follow-up. CONCLUSION: Most patients with KD younger than three months of age have atypical presentations and a high complication rate. For early diagnosis, erythema at the BCG inoculation site, if present, could be used as a valid diagnostic clue to atypical KD in this age group.
