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

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.