SAN DIEGO — African American children with Kawasaki disease are more likely to have higher 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 sponsored by the American Heart Association.
“At this time, I can't say there is a take-home message,” Dr. Balfour, a pediatric cardiologist with Saint Louis University, said 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 January 1995 and December 31, 2002, with a diagnosis of Kawasaki disease. They analyzed 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.
More black patients presented with Kawasaki disease before age 6 years than 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 black children also had significantly higher mean erythrocyte sedimentation rates (72.9 mm/hr vs. 55.9 mm/hr) and C-reactive protein levels (22.3 mg/L vs. 6.9 mg/L) than their white counterparts.
Dr. Balfour noted that coronary artery involvement was similar between the two groups.