SAN DIEGO — African American children with Kawasaki disease are more likely to have higher documented fevers in the hospital, higher erythrocyte sedimentation rates, and higher C-reactive protein levels than their white counterparts, Ian C. Balfour, M.D., reported in a poster session at an international Kawasaki disease symposium.
Although the disparity may be related to genetic differences between African Americans and whites, Dr. Balfour noted that more research is needed to further understand the association.
“At this time, I can't say there is a take-home message,” Dr. Balfour, a pediatric cardiologist with St. Louis University, told FAMILY PRACTICE NEWS in an interview. “I think we need further study to determine why certain patients have higher erythrocyte sedimentation rates and higher levels of C-reactive protein.”
For the study, which he called the first of its kind, Dr. Balfour and his associates reviewed the records of 124 children admitted to Cardinal Glennon Children's Hospital in St. Louis between Jan. 1, 1995, and Dec. 31, 2002, with a diagnosis of Kawasaki disease.
The investigators used analysis of variance and chi-squared testing to analyze multiple clinical parameters in relation to ethnic origin.
Of the 124 children, 76 (61%) were white, 38 (31%) were African American, 7 (6%) were Asian, and 3 (2%) were from other ethnic groups. Age at presentation ranged from 2 to 11 years.
Because the number of Asian patients and those from other ethnicities was so small, Dr. Balfour only discussed clinical differences between African American and white children.
A greater number of African American patients presented with Kawasaki disease before age 6 years, compared with white patients (97.4% vs. 76.3%), but the difference was not statistically significant.
African American children had significantly higher mean fever upon hospital admission, compared with white children (102.2° F vs. 101.3° F).
The African American children also had significantly higher mean erythrocyte sedimentation rates (72.9 mm/hr vs. 55.9 mm/hr).
C-reactive protein levels also differed significantly between the two groups. African American children had mean C-reactive protein levels of 22.3 mg/L vs. 6.9 mg/L among their white counterparts.
Dr. Balfour noted that coronary artery involvement was similar between the two groups.
The symposium was sponsored by the American Heart Association.