European Journal of Pediatrics

, Volume 172, Issue 3, pp 343–349

Incomplete clinical manifestation as a risk factor for coronary artery abnormalities in Kawasaki disease: a meta-analysis

  • Kee-Soo Ha
  • GiYoung Jang
  • JungHwa Lee
  • KwangChul Lee
  • YoungSook Hong
  • ChangSung Son
  • JooWon Lee
Original Article

DOI: 10.1007/s00431-012-1891-5

Cite this article as:
Ha, K., Jang, G., Lee, J. et al. Eur J Pediatr (2013) 172: 343. doi:10.1007/s00431-012-1891-5

Abstract

Incomplete Kawasaki disease (KD) comprises a large proportion of the total number of cases. Although it has the potential of delaying diagnosis, it is not conclusive whether an incomplete presentation is a risk factor for coronary artery abnormalities (CAAs). We performed a meta-analysis to establish the risk of CAA in 20 studies including 4,504 cases and 32,519 controls, and the risk of giant aneurysm in two studies including 5,390 cases and 37,648 controls. The pooled results indicated that incomplete KD was associated with an increased risk of CAA [odds ratio (OR) = 1.447, 95 % confidence interval (CI) = 1.158–1.808, p = 0.001]. Subgroup analyses demonstrated higher associations in patients younger than 12 months (OR = 2.023, 95 % CI = 1.252–3.271, p = 0.004), Asians and Indians (OR = 1.57, 95 % CI = 1.234–1.999, p < 0.001 and OR = 7.088, 95 % CI = 1.640–30.631, p = 0.009, respectively). Subgroup analysis according to the period of patient enrollment before and after 2004 showed increased association of incomplete KD with CAA only among studies with patients enrolled after 2004 (OR = 1.969, 95 % CI = 1.240–3.127, p = 0.004). In conclusion, incomplete KD seems to be associated with an increased risk of CAA, and this is more prominent in patients younger than 12 months, Asians and Indians.

Keywords

AneurysmCoronary artery abnormalityKawasaki disease–incompleteMeta-analysis

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Kee-Soo Ha
    • 1
  • GiYoung Jang
    • 2
  • JungHwa Lee
    • 1
  • KwangChul Lee
    • 3
  • YoungSook Hong
    • 2
  • ChangSung Son
    • 3
  • JooWon Lee
    • 1
  1. 1.Department of PediatricsKorea University Medical Center Guro HospitalSeoulRepublic of Korea
  2. 2.Department of PediatricsKorea University Medical Center Ansan HospitalAnsan-siRepublic of Korea
  3. 3.Department of PediatricsKorea University Medical Center Anam HospitalSeoulRepublic of Korea