Significance of Differential Characteristics in Infantile Kawasaki Disease
- Authors
- Kwak, Ji Hee; Lee, JungHwa; Ha, Kee Soo
- Issue Date
- 8월-2019
- Publisher
- KOREAN SOC CARDIOLOGY
- Keywords
- Kawasaki disease; Infant; Differential leukocyte count; Hemoglobin
- Citation
- KOREAN CIRCULATION JOURNAL, v.49, no.8, pp.755 - 765
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN CIRCULATION JOURNAL
- Volume
- 49
- Number
- 8
- Start Page
- 755
- End Page
- 765
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/63614
- DOI
- 10.4070/kcj.2018.0434
- ISSN
- 1738-5520
- Abstract
- Background and Objectives: Immunological variability in Kawasaki disease (KD) shows age-specific differences; however, specific differences in laboratory values have not been compared between infants and non-infants with KD. We compared age-adjusted Z-values (Z) of white and red blood cells in infants with KD with those in non-infants with KD. Methods: This study retrospectively investigated 192 infants and 667 non-infants recruited between 2003 and 2015 at the Korea University Hospital. Laboratory values for infants with KD and non-infants with KD were analyzed and age-unadjusted raw values (R) and age-adjusted Z for blood cells counts were determined. Results: Z in infants with KD during pre-intravenous immunoglobulin (IVIG), post-IVIG, and chronic phases showed increased lymphopenia and eosinophilia, low neutrophil: lymphocyte and neutrophil: eosinophil ratios, worse anemia, increased thrombocytosis, and reduced erythrocyte sedimentation rates compared with those in non-infants with KD. The optimal cut-off value for pre-IVIG Z-hemoglobin for prediction of KD in all patients was <-0.01 (area under the curve [AUC], 0.914; sensitivity/specificity, 0.999/0.886; p=0.04). The optimal cutoff value for pre-IVIG C-reactive protein (CRP) for prediction of KD in infants compared to that in febrile control infants was >40 mg/L (AUC, 0.811; sensitivity/specificity, 0.712/0.700; p=0.04). Conclusions: Laboratory characteristics enable differentiation between infants and non-infants with KD and contribute to a better understanding of changes in blood cell counts. Infants with incomplete KD can be more easily differentiated from infants with simple febrile illness using pre-IVIG Z-hemoglobin and pre-IVIG CRP values.
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