Published online August 24, 2009
PEDIATRICS Vol. 124 No. 3 September 2009, pp. e410-e415 (doi:10.1542/peds.2009-0099)
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ARTICLE

Kawasaki Disease at the Extremes of the Age Spectrum

Cedric Manlhiot, BSca, Rae S. M. Yeung, MD, PhDb, Nadia A. Clarizia, BSca, Nita Chahal, MN, CNS-NPa and Brian W. McCrindle, MD, MPHa

Divisions of a Cardiology
b Rheumatology, Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, Canada

OBJECTIVE: We sought to determine outcomes of Kawasaki disease (KD) and to explore factors associated with poor clinical outcomes for patients diagnosed outside the age range of 1 to 4 years.

METHODS: A retrospective review of data for all patients seen between January 1990 and April 2007 was performed. Patients were stratified into 5 groups on the basis of age at diagnosis.

RESULTS: A total of 1374 patients were identified; 61 (4%) were <6 months of age at diagnosis, 114 (8%) 6 months to <1 year, 854 (62%) 1 to 4 years, 258 (19%) 5 to 9 years, and 87 (6%) >9 years. Patients <1 year of age and those >9 years of age were more likely to have coronary artery abnormalities than were patients diagnosed between 1 and 4 years of age. Patients diagnosed between the ages of 5 and 9 years were at the lowest risk. Patients at both extremes of the age spectrum were more likely to present with <4 of the classic KD features, but only those <6 months or >5 years of age were at increased risk of being diagnosed >12 days after illness onset. Patients <6 months of age had lower albumin levels, and those <1 year of age had higher white blood cell and platelet counts, all of which are known predictors of coronary artery abnormalities. Patients >9 years of age were less likely to receive intravenous immunoglobulin treatment.

CONCLUSION: Outcomes for children diagnosed with KD at either extreme of the age spectrum are suboptimal, although the associated factors are different.

Key Words: Kawasaki disease • epidemiology • coronary artery abnormalities

Abbreviations: KD—Kawasaki disease • IVIG—intravenous immunoglobulin

Accepted Apr 14, 2009.


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Kawasaki Disease Outside the Usual Age Range
Journal Watch Infectious Diseases, September 23, 2009; 2009(923): 6 - 6.
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