Clinical Significance of Late Onset Arthritis in Kawasaki Disease

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. We retrospectively reviewed the records of 524 patients between March 2006 and February 2016. 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. 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.