Kawasaki disease in children and adolescents: clinical data of Kawasaki patients in a western region (Tyrol) of Austria from 2003–2012

Abstract

BackgroundKawasaki disease (KD) is a rare vasculitis seen predominantly in children. In developing countries, it is the leading cause of childhood-acquired heart disease. Besides a case report from 1981 there have been no data published dealing with the epidemiology and clinical aspects of KD in Austria.MethodsThe purpose of the present study was to investigate the clinical spectrum of KD in a geographically determined cohort of infants, children, and adolescents that were diagnosed and treated at the University Hospital of Innsbruck from 2003–2012.ResultsThirty-two patients were included in the study with a median age of 32.96 months (2–192). 59.4% of the patients were aged between six months and four years. The male-to-female ratio was 1:1.13. Clinical examination revealed non-purulent conjunctivitis and exanthema as the most common symptoms (84.4%). 75% showed oropharyngeal changes, 21.9% had gastrointestinal complaints such as diarrhoe, stomachache or vomiting prior to diagnosis. One third of the patients were admitted with a preliminary diagnosis, whereas 78.1% were pre-treated with antibiotics. The median fever duration at the time of presentation was estimated with 4.96 days (1–14), at time of diagnosis 6.76 days (3–15).75% were diagnosed with complete KD, and 25% with an incomplete form of the disease. There was no significant difference in the duration of fever neither between complete and incomplete KD, nor between the different age groups. Typical laboratory findings included increased C-reactive protein (CRP) (80.6%) and erythrocyte sedimentation rate (ESR) (96%),leukocytosis (48.4%) and thrombocytosis (40.6%) without any significant quantitative difference between complete and incomplete KD. Coronary complications could be observed in six patients: one with a coronary aneurysm and five with tubular dilatation of the coronary arteries. Our patient cohort represents the age distribution as described in literature and emphasizes that KD could affect persons of any age. The frequency of occurrence of the clinical symptoms differs from previous reports – in our study, we predominantly observed non-purulent conjunctivitis and exanthema.ConclusionKD should always be considered as a differential diagnosis in a child with fever of unknown origin, as treatment can significantly decrease the frequency of coronary complications.Electronic supplementary materialThe online version of this article (doi:10.1186/1546-0096-12-37) contains supplementary material, which is available to authorized users.

Correlations between inflammatory response and lymphocyte percentage or CD19+ B cell count in Kawasaki disease children at different ages undergoing intravenous immunoglobulin: a retrospective study

“…Other studies reported the disease more frequently occured in boys [16,17]. However, our result has a discrepancy with those results, but is consistent with the data recently reported from Australia [18]. On this issue, a study including a larger number of patients will lead to more convincing conclusion.…”

Correlations between inflammatory response and the increased lymphocyte percentage or CD19+ cell count in Kawasaki disease children undergoing intravenous immunoglobulin in different age intervals

“…In the presented study, 60 cases of KD patients were involved in this retrospective analysis and divided into 5 groups according to the children's different age interval. There are no obvious differences in the sex distribution as to the incidence of KD in all groups, which has a discrepancy with other studies showing the disease more frequently occurs in boys [13,14] but is consistent with the data recently reported in Australia [15]. A larger number of patients enrolled will have more convictive conclusion in this issue.…”

Correlations between inflammatory response and percentage of lymphocyte or CD19+ B cell count in Kawasaki disease children of different ages undergoing intravenous immunoglobulin: a retrospective study

“…There are no obvious differences in the sex distribution in terms of the incidence of KD in all groups. This result shows a discrepancy with other studies, which show the disease more frequently occurs in boys [14,15] but is consistent with the data recently reported in Australia [16]. On this issue, including a larger number of patients will lead to more convincing conclusion.…”