Kawasaki disease in infants 3 months of age and younger: a multicentre Spanish study

Kawasaki disease (KD) is a multisystem vasculitis of small and medium vessels typical of childhood. Timely treatment with intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery abnormalities (CAAs) from 25% to approximately 4%.1 Asian studies have focused on infants under 3 months of age, but there are no published data about these patients from Western countries.2 3 We reviewed 621 patients under 16 years old with a diagnosis of KD between 2011 and 2016 from a multicentre study in Spain (KAWA-RACE study); 84 hospitals participated throughout the country. We found seven children under 90 days (1.13%), with a male predominance (6 of 7). Five presented irritability, but only two fulfilled the criteria for complete KD (table 1).1 The following were the main laboratory findings (median, IQR): highest C reactive protein (CRP) 24 mg/L (8.48–31.4), highest erythrocyte sedimentation rate 79 mm (70–105.5), maximum and minimum platelet count 900 ×10^9/L (682–1 117) and 506 ×10^9/L (449–612), minimum haemoglobin 10 g/dL (9–10.8), maximum leucocytes 21 ×10^9/L (16.45–23.37), minimum sodium 135.5 mEq/L (133–137.5), and minimum albumin 2.9 mg/dL (2.6–3.4). View this table: Table 1 Diagnosis, symptoms, cardiological and microbiological findings In three cases, a viral infection was diagnosed and four patients presented with CAA, but no other echocardiographic findings were detected (table 1). The median time interval since fever onset to IVIG administration was 8 days. All patients responded well to the first dose of IVIG, and only one received concomitant intravenous steroids because he was considered to be at high risk for IVIG resistance. All CAAs were transient and resolved during follow-up (table 1). Epidemiology is different in Western countries when compared with Asian …