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Clinical Characteristics of Kawasaki Syndrome and the Risk Factors for Coronary Artery Lesions in China

Ruan, Yu MD; Ye, Bei MD; Zhao, Xiaodong MD, PhD

The Pediatric Infectious Disease Journal: October 2013 - Volume 32 - Issue 10 - p e397–e402
doi: 10.1097/INF.0b013e31829dd45e
Original Studies

Background: Kawasaki syndrome (KS) is the leading cause of acquired heart disease in childhood in developed countries. This study was designed to identify the clinical characteristics of a large cohort of KS in China and explore the risk factors for coronary artery lesions.

Methods: Clinical records of 1370 patients with acute KS were retrospectively reviewed. The clinical features of different age groups were analyzed, and a multivariate logistic regression analysis was performed to identify the risk factors for coronary artery lesions caused by KS.

Results: The prevalence of redness at a Bacille Calmette-Guèrin inoculation site was greatest in infants younger than 6 months (18.4%), whereas cervical lymphadenopathy was more frequent in patients older than 60 months (61.5%). Age, sex, therapeutic time, intravenous immunoglobulin dose, platelet count and erythrocyte sedimentation rate were risk factors for coronary artery lesions (P < 0.05). A total fever duration >10 days was a risk factor for coronary artery aneurysms in patients with coronary artery lesions (P < 0.05).

Conclusions: KS occurs more frequently in children younger than 5 years, in boys and during the summer months. Redness at a Bacille Calmette-Guèrin inoculation site signals the diagnosis of incomplete KS in infants and young children. Male gender, younger age, intravenous immunoglobulin dose, delayed administration (>10 days), high platelet level and elevated erythrocyte sedimentation rate are predictive for coronary artery lesions, and total fever duration (>10 days) is predictive for coronary artery aneurysms in patients with coronary artery lesions.

From the Division of Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Accepted for publication May 28, 2013.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Xiaodong Zhao, MD, PhD, Division of Immunology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China. E-mail: zhaoxd530@yahoo.com.cn.

© 2013 by Lippincott Williams & Wilkins, Inc.