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Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months

Objectives: To explore the characteristics of Kawasaki disease (KD) under 6 months and to investigate the possible indications of incomplete KD (iKD). Methods: The medical records of KD patients hospitalized in Children's Hospital of Soochow University from January 2007 to December 2017 were re...

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Autores principales: Tang, Yunjia, Li, Xuan, Cao, Lei, Chen, Ye, Yan, Wenhua, Xu, Qiuqin, Lv, Haitao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456885/
https://www.ncbi.nlm.nih.gov/pubmed/32923416
http://dx.doi.org/10.3389/fped.2020.00470
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author Tang, Yunjia
Li, Xuan
Cao, Lei
Chen, Ye
Yan, Wenhua
Xu, Qiuqin
Lv, Haitao
author_facet Tang, Yunjia
Li, Xuan
Cao, Lei
Chen, Ye
Yan, Wenhua
Xu, Qiuqin
Lv, Haitao
author_sort Tang, Yunjia
collection PubMed
description Objectives: To explore the characteristics of Kawasaki disease (KD) under 6 months and to investigate the possible indications of incomplete KD (iKD). Methods: The medical records of KD patients hospitalized in Children's Hospital of Soochow University from January 2007 to December 2017 were retrospectively reviewed and analyzed. A total of 50 cases of urinary tract infection (UTI) and 50 cases of adenovirus (ADV)-infected patients under 6 months that were age and gender-matched with the main complaint of high fever were selected as controls. Results: A total of 1,872 KD patients were enrolled. Among them, 194 (10.4%) were infantile patients under 6 months. There were 72 (37.1%) and 494 (29.4%) iKD in patients younger and older than 6 months, respectively (P < 0.05). Although patients under 6 months had a shorter fever duration before immunoglobulin (IVIG) treatment, a larger proportion of these patients had IVIG resistance and coronary artery lesions. They also tended to have higher platelet (PLT) counts and C-reactive protein (CRP) and lower hemoglobin (Hb), percentage of neutrophils (N%), albumin and serum sodium. When we compared iKD under 6 months with UTI and ADV-infected patients, significant differences were found in white blood cells (WBC), Hb, PLT, CRP, N% and serum albumin (P < 0.05). After adjusting the confounders, Hb < 105.5 g/L, CRP > 22.7 mg/L, N% > 47.4 and PLT > 496 × 10(9)/L were indications of iKD when compared with ADV infection (area under the curve [AUC]: 0.872, 0.939, 0.707, and 0.684, respectively). N% > 51.8 and albumin < 39.0 g/L were indications of iKD when compared with UTI (AUC: 0.627 and 0.832, respectively). Conclusions: Infantile KD patients under 6 months had their own particularity. Laboratory variables could be good indications of iKD when compared with UTI and ADV infection.
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spelling pubmed-74568852020-09-11 Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months Tang, Yunjia Li, Xuan Cao, Lei Chen, Ye Yan, Wenhua Xu, Qiuqin Lv, Haitao Front Pediatr Pediatrics Objectives: To explore the characteristics of Kawasaki disease (KD) under 6 months and to investigate the possible indications of incomplete KD (iKD). Methods: The medical records of KD patients hospitalized in Children's Hospital of Soochow University from January 2007 to December 2017 were retrospectively reviewed and analyzed. A total of 50 cases of urinary tract infection (UTI) and 50 cases of adenovirus (ADV)-infected patients under 6 months that were age and gender-matched with the main complaint of high fever were selected as controls. Results: A total of 1,872 KD patients were enrolled. Among them, 194 (10.4%) were infantile patients under 6 months. There were 72 (37.1%) and 494 (29.4%) iKD in patients younger and older than 6 months, respectively (P < 0.05). Although patients under 6 months had a shorter fever duration before immunoglobulin (IVIG) treatment, a larger proportion of these patients had IVIG resistance and coronary artery lesions. They also tended to have higher platelet (PLT) counts and C-reactive protein (CRP) and lower hemoglobin (Hb), percentage of neutrophils (N%), albumin and serum sodium. When we compared iKD under 6 months with UTI and ADV-infected patients, significant differences were found in white blood cells (WBC), Hb, PLT, CRP, N% and serum albumin (P < 0.05). After adjusting the confounders, Hb < 105.5 g/L, CRP > 22.7 mg/L, N% > 47.4 and PLT > 496 × 10(9)/L were indications of iKD when compared with ADV infection (area under the curve [AUC]: 0.872, 0.939, 0.707, and 0.684, respectively). N% > 51.8 and albumin < 39.0 g/L were indications of iKD when compared with UTI (AUC: 0.627 and 0.832, respectively). Conclusions: Infantile KD patients under 6 months had their own particularity. Laboratory variables could be good indications of iKD when compared with UTI and ADV infection. Frontiers Media S.A. 2020-08-14 /pmc/articles/PMC7456885/ /pubmed/32923416 http://dx.doi.org/10.3389/fped.2020.00470 Text en Copyright © 2020 Tang, Li, Cao, Chen, Yan, Xu and Lv. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Tang, Yunjia
Li, Xuan
Cao, Lei
Chen, Ye
Yan, Wenhua
Xu, Qiuqin
Lv, Haitao
Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title_full Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title_fullStr Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title_full_unstemmed Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title_short Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months
title_sort characteristics and indications of kawasaki disease among infants under 6 months
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456885/
https://www.ncbi.nlm.nih.gov/pubmed/32923416
http://dx.doi.org/10.3389/fped.2020.00470
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