Early diagnosis and clinical characterization of complete versus incomplete Kawasaki disease in children in Rui'an City: a retrospective study

Backgrounds: The aim of this study was to analyze the clinical characteristics of complete Kawasaki disease (CKD) and incomplete Kawasaki disease (IKD) in children in Rui’an City, with a view to providing a basis for early recognition of IKD by clinicians. Methods: 94 children with suspected Kawasaki disease (KD) admitted to our hospital between October 2017 and October 2023 were selected as the study subjects. Results: The duration of fever in the IKD group was significantly longer than that in the CKD group (p < 0.05), while the incidence of rash, fingertip changes, conjunctival congestion, and cervical lymph node enlargement were significantly lower than that in the CKD group (p < 0.05). In contrast to the CKD group, the IKD group exhibited significantly elevated levels of C-reactive protein (CRP), platelet count (PLT), N-terminal brain natriuretic peptide precursor (NT-proBNP) and albumin (ALB) (p < 0.05), whereas the level of alanine aminotransferase (ALT) was significantly lower (p < 0.05). In the IKD group, a greater percentage of children exhibited sinus tachycardia compared to the CKD group (p < 0.05). The incidence of coronary artery lesions (CAL) was significantly higher in the IKD group than in the CKD group (p < 0.05). There were 14 cases (15.91%) in the IKD group and 6 cases (6.38%) in the CKD group showed resistance to gammaglobulin treatment (χ2 = 4.217, p = 0.040). Conclusions: Children with IKD experienced prolonged fever duration, a notably reduced rate of positive clinical symptoms, and marked irregularities in lab parameters such as CRP, PLT, NT-proBNP and ALB, as well as a significantly higher incidence of CAL. A thorough examination incorporating data from various angles in clinical settings can provide valuable insights for diagnosing and treating pediatric patients with IKD in Rui’an City.