Clinical similarities and differences in Kawasaki disease during 1991-2001 and 2002-2011 periods / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the changes in clinical characteristics of Kawasaki disease (KD) between the first and the second decade and improve the diagnosis and treatment of incomplete KD.Methods Retrospective analysis of clinical data of children with KD was performed in the Second Affiliated Hospital of Guangzhou Medical Coliege during the recent 20 years (between Dec.1991 and Dec.2011).The changes in clinical manifestations of KD were compared between the first l0 years and the second l0 years.A total of 270 hospitalized patients diagnosed as KD were included in this study.The patients admitted after Dec.2001 were assigned as the observation group (192 cases) and those admitted before Dec.2001 were assigned as the control group (78 cases).The epidemiologic characteristics,clinical manifestations,impairment of organs,and laboratory findings were compared between the 2 groups and statistic analysis was performed on the available date.Results 1.The rate of KD patients ＜ 1-year-old and the incidence of incomplete KD in the observation group were significantly higher than those in the control group (all P ＜0.01) ; 2.The incidences of rash,changes in oral mucosa,congestion of conjunctiva,hardening edema of hands and feet,lymph node enlargement in the observation group were significantly lower than those in the control group (all P ＜ 0.01) ; 3.Incidence of coronary artery impairment in the observation group was significantly higher than that in the control group (P ＜ 0.05) ; 4.There were no significant differences for inflammation index between the 2 groups (all P ＞ 0.05).Conclusions The incidence of KD and the number of cases with incomplete KD increased in the last decade,especially in younger infants,and the incidence of coronary arteries impairment is increased.To incomplete KD,combining clinical manifestations with laboratory findings of inflammation index are needed for early diagnosis.