S Singh1, M K Gupta, A Bansal, R M Kumar, B R Mittal. 1. Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. surjitsinghpgi@rediffmail.com
Abstract
OBJECTIVE: Clinical experience collated over the last 11 years at our center suggests that Kawasaki disease (KD) affects older children more frequently as compared to the Western literature. In this study we have compared the clinical profile of KD in children above 5 years of age (Group I) with those below 5 years (Group II). DESIGN: Chart review of children with KD during the period January 1994-April 2006. RESULTS: Of the 97 children, 38 (39.2%) were in Group I and 59 (60.8%) were in Group II. Mean age at presentation of children in Group I was 8.12 +/- 2.0 years while that in Group II was 2.83 +/- 1.50 years. Mean time interval to make the diagnosis was 11.2 +/- 6.4 days in Group I as compared to 10.8 +/- 6.03 days Group II but the difference was not significant (p > 0.05). Non-purulent conjunctivitis, mucosal changes in oropharynx, cervical lymphadenopathy and hepatomegaly were seen more frequently in Group II than in Group I, but this difference was also not statistically significant. Desquamation at presentation and arthralgia/arthritis were significantly more common in Group I, while edema over hands and feet was significantly more frequent in Group II (p < 0.05). Among laboratory parameters, hemoglobin level was lower in children in Group II as compared to Group I (p = 0.001), while there was no difference in parameters of inflammation. Cardiac abnormalities were noted in about 12% children but there was no statistically significant difference between the two groups. CONCLUSION: In Chandigarh, KD occurs more frequently in children above 5 years of age as compared to the West. Older children with KD have a different clinical profile. However, cardiac complications do not differ between the 2 groups.
OBJECTIVE: Clinical experience collated over the last 11 years at our center suggests that Kawasaki disease (KD) affects older children more frequently as compared to the Western literature. In this study we have compared the clinical profile of KD in children above 5 years of age (Group I) with those below 5 years (Group II). DESIGN: Chart review of children with KD during the period January 1994-April 2006. RESULTS: Of the 97 children, 38 (39.2%) were in Group I and 59 (60.8%) were in Group II. Mean age at presentation of children in Group I was 8.12 +/- 2.0 years while that in Group II was 2.83 +/- 1.50 years. Mean time interval to make the diagnosis was 11.2 +/- 6.4 days in Group I as compared to 10.8 +/- 6.03 days Group II but the difference was not significant (p > 0.05). Non-purulent conjunctivitis, mucosal changes in oropharynx, cervical lymphadenopathy and hepatomegaly were seen more frequently in Group II than in Group I, but this difference was also not statistically significant. Desquamation at presentation and arthralgia/arthritis were significantly more common in Group I, while edema over hands and feet was significantly more frequent in Group II (p < 0.05). Among laboratory parameters, hemoglobin level was lower in children in Group II as compared to Group I (p = 0.001), while there was no difference in parameters of inflammation. Cardiac abnormalities were noted in about 12% children but there was no statistically significant difference between the two groups. CONCLUSION: In Chandigarh, KD occurs more frequently in children above 5 years of age as compared to the West. Older children with KD have a different clinical profile. However, cardiac complications do not differ between the 2 groups.