Clinical Characteristics Of 214 Cases Of Incomplete Kawasaki Disease

Objective:To analyze the general information of incomplete Kawasaki disease(IKD),compare the clinical manifestations and related hematological indexes during hospitalization with that of typical Kawasaki disease(TKD)in the same period,early recognition of incomplete Kawasaki disease were enhanced.The factors related to coronary artery lesions in incomplete Kawasaki disease have been further explored.Methods:A retrospective analysis of 214 cases of incomplete Kawasaki disease(IKD)hospitalized in the Children’s Hospital of Soochow University from August 2014 to July 2018 was conducted.Compared with 217 cases of typical Kawasaki disease(TKD)randomly sampled in the same period,the general condition,the major clinical manifestations,laboratory serological markers and intravenous immunoglobulin response were analyzed.Univariate correlation analysis and regression analysis were conducted to find risk factors for incomplete Kawasaki disease complicated with coronary artery lesions(CAL).Results:(1)The incidence of incomplete Kawasaki disease peaked in spring and summer.The affected population was mainly children under 5 years old,and the age group within 1 year old was the most.There is no significant difference in the number of cases among different age groups in four seasons.There were more male patients than female patients,and the ratio of male to female was(119:95)1.25:1.(2)The duration of fever in incomplete Kawasaki disease group were longer compared with those in typical Kawasaki disease group.The occurrence of intravenous immunoglobulin resistance was not significantly different in the two groups.The onset age of incomplete Kawasaki disease group was younger than that of typical Kawasaki disease group.The incidence of main clinical manifestations including hyperemia,oral changes,limb changes,cervical lymphadenopathy and rash were less than those in Kawasaki disease group,except for coronary artery lesion.(3)Both incomplete Kawasaki disease and typical Kawasaki disease showed increased white blood cells(WBC)and C-reactive protein(CRP)without statistical difference.Hemoglobin(HB),percentage of neutrophils(N%),neutrophils-to-lymphocytes ratio(NLR),alanine transaminase(ALT)in incomplete Kawasaki disease group were lower whereas the platelet(PLT)and erythrocyte sedimentation rate(ESR)were higher than those in typical Kawasaki disease group.It can be seen that in the incomplete Kawasaki disease group,the falling of hemoglobin(HB),ascending of platelet(PLT)and erythrocyte sedimentation rate(ESR)were especially notable(P<0.05).There was no significant difference between the two groups.Lymphocyte subsets as the percentage of CD3+、CD3+CD4+、CD3+CD8+were significantly different in two groups(P<0.05).The decrease of CD3+、CD3+CD8+was less pronounced in the incomplete Kawasaki disease(IKD).In incomplete Kawasaki disease group,Mycoplasma pneumoniae infection was the most common combined infection(10.75%),followed by rotavirus and EB virus infection.(4)In the study of the high risk-factors of coronary artery lesion(CAL)in incomplete Kawasaki disease(IKD),The differences in univariate correlation analysis are statistically significant in gender,oral changes,albumin,erythrocyte sedimentation rate.Further regression analysis showed that men,without oral changes and low serum albumin were independent risk factors for incomplete Kawasaki disease(IKD)complicated with CAL.Conclusions:(1)Children in incomplete group were with a prolonged fever duration and a high incidence of coronary artery lesions than in typical Kawasaki Disease(TKD)group.The falling of hemoglobin(HB),ascending of platelet(PLT)and erythrocyte sedimentation rate(ESR)in incomplete Kawasaki disease(IKD)group were more obvious compared with the other group.The percentage of neutrophils,neutrophils-to-lymphocytes ratio,alanine aminotransferase were lower than those in typical Kawasaki disease group,and the proportions of CD3+、CD3+CD8+ declined less pronouncedly in the incomplete group.(2)The independent risk factors for incomplete Kawasaki disease(IKD)complicated with CAL were male,without oral changes,and decreased serum albumin.