Clinical significance of late onset arthritis in kawasaki disease

Objectives: The aim of this study was to report the prevalence, clinical course, and sequela of arthritis in Kawasaki disease (KD), and to establish its relationship to coronary outcomes. Methods: We retrospectively reviewed the records of 524 patients between March 2006 and February 2016. Results: The overall prevalence of arthritis was 17.6% (n = 92/524) and among them, 21 cases (22.8%) had late-onset arthritis and they were older (32.7±12.1 vs. 62.5±23.8 months), had longer fever duration (5.8±1.94 vs. 7.11±2.51 days), more frequent swelling or redness of extremities (35.2 vs. 71.5%), higher neutrophil counts (58.69±13.84 vs. 72.16±16.43%), and higher prohormone brain-type natriuretic peptide levels (ProBNP, 1343.80±1080.44 vs. 3754.42±4272.71 pg/mL) than patients with early onset arthritis. Coronary artery changes were not different and no patients complained of chronic arthritic changes, regardless of arthritis type. Conclusions: Although late-onset arthritis was found in KD patients who were older with longer fever duration, more frequent swelling or redness of extremities, higher neutrophil counts, and higher ProBNP levels than early-onset arthritis patients, there was no statistical significance between arthritis onset type and coronary artery changes, and outcomes were excellent with no chronic arthritis change.