Clinical Characteristics and Outcomes of Kawasaki Disease in Infants Younger than Six Months of Age: Algerian Multicenter Study
Mohammed Mokhtar BEKKAR1,2,3,4*, Karima OULD SAID5, Sidi Mohammed GHOMARI6, Amina TARI1,2,3, Chahrazed MESDOUR1,2,4, Lahouaria CHERIET1,2, Safia ZOUBIR1,2, Salih BENDEDDOUCHE6, Khadidja BENALLEL5 and Sakina NIAR1,2
1 Faculty of Medicine University Oran 1 “Ahmed Ben Bella”, Algeria.
2 Marfan Pediatric Department, Oran University Hospital Center, Algeria.
3 GRAS research laboratory, IEC health team, Algeria.
4 PRFU Research Project: Cardiac involvement of Kawasaki disease, Algeria.
5 Pediatric Department, Sidi Bel Abbes University Hospital Center, Algeria.
6 Pediatric Department, Tlemcen University Hospital Center, Algeria.
*Corresponding Author: Dr. Mohammed Mokhtar BEKKAR, Faculty of Medicine University Oran 1 “Ahmed Ben Bella”, Algeria.
DOI: https://doi.org/10.58624/SVOAPD.2023.02.032
Received: April 13, 2023 Published: April 25, 2023
Abstract
Background and Objectives: Kawasaki disease (KD) is one of the most common immune vasculitis in children and the leading cause of acquired heart disease, which predominantly occurs in children under the age of 5 years. However, there are fewer cases of KD in infants younger than 6 months, making diagnosis more challenging. The objective is to characterize the clinical presentation and evolution of KD in infants < 6 months of age as compared to those ≥6 months in western Algeria.
Methods: We retrospectively reviewed the medical records of 62 patients diagnosed with KD in western Algeria followed between January 2018 and January 2023. The data were categorized into 2 groups by age: Group A (<6 months, n=12) and Group B (≥6 months, n=50). We compared differences in laboratory data, clinical presentation, treatment response, and coronary artery outcomes between the two cohorts.
Results: The majority (78%) of infants and children ≥6 months of age were initially diagnosed with KD, as compared to only 33,3% of infants <6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (90 vs. 75%, P = 0.0023), extremity changes (76 vs. 50 %, P = 0.029), and cervical lymphadenopathy (66 vs. 33.3%, P = 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants <6 months were at greater risk of developing a coronary artery aneurysm compared to KD patients ≥6 months treated at the same point in the course of illness [≤10 days (55 vs. 8,88 %, P = 0.0001) ; >10 days (66,6 vs. 6,6%, P = 0.046)].
Conclusion: Our data show that despite treatment in the first 10 days of illness, infants <6 months of age have a higher risk of developing a coronary artery aneurysm. Delay in the diagnosis leads to larger coronary artery aneurysms disproportionately in these infants. Thus, suspicion for KD should be high in this vulnerable population.
Keywords: kawasaki disease; below 6 months, Mucocutaneous Lymph Node Syndrome; Coronary Aneurysm; Immunoglobulins.
Citation: BEKKAR MM, OULD SAID K, GHOMARI SM, TARI A, MESDOUR C, CHERIET L, ZOUBIR S, BENDEDDOUCHE S, BENALLEL K, NIAR S. Clinical Characteristics and Outcomes of Kawasaki Disease in Infants Younger than Six Months of Age: Algerian Multicenter Study. SVOA Paediatrics 2023, 2:2, 50-58.