Clinical Features and Determinants of Coronary Artery Dilatation in Pediatric Patients with Complete and Incomplete Kawasaki Disease: A Single-Center Experience Over 15 Years in Hubei, China

Abstract

Objective This study is aimed to elucidate age-associated clinical and echocardiography-defined coronary artery (CA) abnormalities features and to identify independent determinants of CA dilatation in pediatric patients with complete Kawasaki disease (cKD) and incomplete KD (iKD) over 15 years in a tertiary hospital in China.

Methods This study comprised 241 patients with KD hospitalized in the pediatric department between 2003 and 2018. Patients were divided into three groups according to age at diagnosis: ≤12, 13 to 35, and ≥36 months.

Results A total of 167 (69.3%) patients were defined as cKD (aged 24 months, male 60.5%) and 74 (30.7%) patients as iKD (aged 18 months, male 59.5%). The prevalence of cervical lymphadenopathy significantly increased with age in both cKD and iKD patients. In iKD patients, the prevalence of rash significantly decreased with age. CA dilatation most frequently occurred in patients with cKD and iKD aged ≤12 months. The absence of conjunctivitis or oral changes and higher serum creatinine levels were independent determinants of CA dilatation in KD patients aged ≤12 months, regardless of age, sex, and the type of KD.

Conclusion Present study underlines the age-stratified disease characteristics, and the factors associated with CA dilatation in cKD and iKD patients. The absence of conjunctivitis or oral changes, higher serum creatinine levels, and mycoplasma, cytomegalovirus, and adenovirus infections might be associated with an increased risk of CA dilatation in KD patients. These findings provide additional hints for pediatricians in the early diagnosis and treatment of KD, especially for individual medical care of cKD and iKD patients in different age groups.

Keywords

Kawasaki disease - coronary artery dilatation - age

Authors' Contributions

Y.-P.D. and, H.-R.X., participated in the design of the study and conceived of the study. Y.-P.D., H.-R.X., and D.X.Z. were contributors in writing the manuscript. Y.-X.Z., X.W., Q.X., and P.L. all assisted in analyzing data. All authors reviewed the manuscript.

Availability of Data and Materials

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Ethical Approval

This study was approved by the Ethics Committee at Zhongnan Hospital of Wuhan University (2021091K) and conducted in accordance with the Declaration of Helsinki. Written informed consent due to applicable provisions was obtained from all patients' guardians.

Publikationsverlauf

Eingereicht: 29. Juni 2023

Angenommen: 24. August 2023

Artikel online veröffentlicht:
29. Oktober 2023

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