Korean Circ J.  2019 Aug;49(8):755-765. 10.4070/kcj.2018.0434.

Significance of Differential Characteristics in Infantile Kawasaki Disease

• Kwak JH
• Lee J
• Ha KS

• KMID: 2456871
• DOI: http://doi.org/10.4070/kcj.2018.0434

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 cut-off 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.

Keyword

Kawasaki disease; Infant; Differential leukocyte count; Hemoglobin

MeSH Terms

Anemia
Blood Cell Count
Blood Cells
Blood Sedimentation
C-Reactive Protein
Eosinophilia
Erythrocytes
Humans
Immunoglobulins
Infant
Korea
Leukocyte Count
Lymphopenia
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies
Thrombocytosis
C-Reactive Protein
Immunoglobulins

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