Abstract 85: Early Detection of Kawasaki Disease in Infants

Abstract

Background and Objective: This study was aimed to investigate 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 66 patients with KD who were admitted to Dongguk University Gyeongju Hospital, between January 2010 and August 2014. The clinical, laboratory data between infants and children were analyzed. And the clinical and laboratory data of infantile KD patients were compared with 18 infants who were admitted for other acute febrile disease during same period as above. Results: A total of 66 patients were identified; 21(31.8%) were infants; 45(68.2%) were > 1 year old children. Incomplete KD was much more common in infants (n=15, 71.4%) than in children group (n=14, 31.1%) (P = 0.002). The infants group was 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 cervical lymphadenopathy (P=0.005), conjunctival injection (P=0.047). The serum levels of hemoglobin were lower (P<0.001), and platelet (P=0.029), C-reactive protein (P=0.042), N-terminal pro-brain natriuretic peptide (NT-proBNP) (P=0.042) was higher in the infants group significantly. Pyuria was also significantly higher in the infants group (P=0.017). Between infants with KD and with other acute febrile diseases, there were significantly higher serum levels of ESR (P<0.001), CRP (P=0.009) and NT-proBNP (P=0.002) in the infantile KD. Conclusion: Because incomplete KD was much more in infants, the diagnosis of infantile KD can be difficult. The BCGitis and higher level of NT-proBNP can help to early diagnosis of incomplete KD in infants, and may be a good predictor of KD in acute febrile infants combined with other acute phase reactants.