Kawasaki Disease at the Extremes of the Age Spectrum

Abstract

OBJECTIVE: We sought to determine outcomes of Kawasaki disease (KD) and to explore factors associated with poor clinical outcomes for patients diagnosed outside the age range of 1 to 4 years. METHODS: A retrospective review of data for all patients seen between January 1990 and April 2007 was performed. Patients were stratified into 5 groups on the basis of age at diagnosis. RESULTS: A total of 1374 patients were identified; 61 (4%) were 9 years. Patients 9 years of age were more likely to have coronary artery abnormalities than were patients diagnosed between 1 and 4 years of age. Patients diagnosed between the ages of 5 and 9 years were at the lowest risk. Patients at both extremes of the age spectrum were more likely to present with 5 years of age were at increased risk of being diagnosed >12 days after illness onset. Patients 9 years of age were less likely to receive intravenous immunoglobulin treatment. CONCLUSION: Outcomes for children diagnosed with KD at either extreme of the age spectrum are suboptimal, although the associated factors are different.