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Background <p>Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects children; aseptic meningitis is the most common neurological complication of KD. This study aims to describe the clinical features, treatment, and prognosis of KD with aseptic meningitis.</p> Methods <p>This single-center, retrospective study included 13 patients with KD complicated by aseptic meningitis admitted to the Women and Children’s Hospital of Ningbo University from January 2018 to October 2022. Additionally, 125 patients with KD but without aseptic meningitis were selected as controls. Clinical features and laboratory findings were compared between the two groups. Statistical analysis was performed using the <i>t</i>-test for normally distributed data, nonparametric tests for non-normally distributed continuous variables, and Fisher’s exact test for categorical variables.</p> Results <p>Thirteen patients with KD complicated by aseptic meningitis were enrolled, including 10 males and 3 females. The median age was 4.06&#xa0;months. Compared to the control group, they exhibited a significantly younger age of onset, a higher likelihood of presenting with incomplete KD, and a higher proportion of congenital heart disease (<i>P</i> &lt; 0.05). Levels of C-reactive protein (CRP), aspartate aminotransferase (AST), total bile acid (TBA), serum prealbumin (SPA), and high-density lipoprotein (HDL) were significantly higher, while alanine aminotransferase (ALT) levels were significantly lower (<i>P</i> &lt; 0.05). Brain magnetic resonance imaging (MRI) revealed abnormalities in eight cases. Cerebrospinal fluid (CSF) analysis showed that the median white blood cell (WBC) count was 20 × 10<sup>⁶</sup>/L, the median chloride level was 121&#xa0;mmol/L, the median glucose level was 3.87&#xa0;mmol/L, the median lactate dehydrogenase (LDH) level was 31 U/L, and the median protein concentration was 51.9&#xa0;mg/dL. All patients received intravenous immunoglobulin (IVIG), and one patient required additional glucocorticoid therapy. All patients were discharged from the hospital, and no neurological sequelae were observed after 3&#xa0;months of follow-up.</p> Conclusion <p>KD can be complicated with aseptic meningitis. In young patients presenting with incomplete KD and neurological symptoms, elevated levels of CRP, AST, TBA, SPA, and HDL, along with low ALT, should raise suspicion for KD complicated by aseptic meningitis. The prognosis for this condition is generally favorable, highlighting the importance of timely KD treatment to improve outcomes.</p>

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Clinical features and laboratory findings of Kawasaki disease with aseptic meningitis: a retrospective case–control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Yu Shen,
  • Jian Chen,
  • Yun-Yan Li,
  • Wei-Hui Lu,
  • Li-Li Chen,
  • Bei-Rong Yu

摘要

Background

Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects children; aseptic meningitis is the most common neurological complication of KD. This study aims to describe the clinical features, treatment, and prognosis of KD with aseptic meningitis.

Methods

This single-center, retrospective study included 13 patients with KD complicated by aseptic meningitis admitted to the Women and Children’s Hospital of Ningbo University from January 2018 to October 2022. Additionally, 125 patients with KD but without aseptic meningitis were selected as controls. Clinical features and laboratory findings were compared between the two groups. Statistical analysis was performed using the t-test for normally distributed data, nonparametric tests for non-normally distributed continuous variables, and Fisher’s exact test for categorical variables.

Results

Thirteen patients with KD complicated by aseptic meningitis were enrolled, including 10 males and 3 females. The median age was 4.06 months. Compared to the control group, they exhibited a significantly younger age of onset, a higher likelihood of presenting with incomplete KD, and a higher proportion of congenital heart disease (P < 0.05). Levels of C-reactive protein (CRP), aspartate aminotransferase (AST), total bile acid (TBA), serum prealbumin (SPA), and high-density lipoprotein (HDL) were significantly higher, while alanine aminotransferase (ALT) levels were significantly lower (P < 0.05). Brain magnetic resonance imaging (MRI) revealed abnormalities in eight cases. Cerebrospinal fluid (CSF) analysis showed that the median white blood cell (WBC) count was 20 × 10⁶/L, the median chloride level was 121 mmol/L, the median glucose level was 3.87 mmol/L, the median lactate dehydrogenase (LDH) level was 31 U/L, and the median protein concentration was 51.9 mg/dL. All patients received intravenous immunoglobulin (IVIG), and one patient required additional glucocorticoid therapy. All patients were discharged from the hospital, and no neurological sequelae were observed after 3 months of follow-up.

Conclusion

KD can be complicated with aseptic meningitis. In young patients presenting with incomplete KD and neurological symptoms, elevated levels of CRP, AST, TBA, SPA, and HDL, along with low ALT, should raise suspicion for KD complicated by aseptic meningitis. The prognosis for this condition is generally favorable, highlighting the importance of timely KD treatment to improve outcomes.