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Rheumatology International

, Volume 35, Issue 6, pp 1053–1058 | Cite as

Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience

  • Lorna Stemberger MaricEmail author
  • Ivica Knezovic
  • Neven Papic
  • Branko Mise
  • Srdan Roglic
  • Leo Markovinovic
  • Goran Tesovic
Short Communication - Observational Research

Abstract

Kawasaki disease (KD) is an acute systemic vasculitis of childhood. Due to development of coronary artery aneurysms (CAA) it is considered the most common cause of acquired heart disease in children. The clinical and laboratory features of patients with complete and incomplete KD were compared in order to identify the possible predictors of CAA development. A cross-sectional study of children with KD treated at the University Hospital for Infectious Diseases, Zagreb, between January 2003 and December 2012 was conducted. A total of 111 KD patients were included; 70.3 % patients had complete KD. Patients with complete KD had more frequently rash, changes on extremities and mucous membranes, as well as higher serum bilirubin, aminotransferases, gamma-glutamyl transferase and lactate dehydrogenase levels. Patients with incomplete KD had longer duration of fever before the diagnosis (8 vs. 7 days) and delayed IVIG treatment (day 8 vs. 7). CAA was detected in seven children (6.3 %). Disease duration before hospitalization >6 days (OR 7.16, 95 % CI 1.51–100.35), age <6 months (OR 25.86, 95 % CI 1.68–398.35) and platelet count >771 after the 7th day of disease (OR 13.33, 95 % CI 2.19–80.87) were independently associated with CAA development. The diagnosis and treatment in incomplete KD can be delayed due to the absence of major criteria. Age, duration of symptoms prior hospitalization and platelet count were identified as independent predictors of CAA development.

Keywords

Kawasaki disease Incomplete Kawasaki disease Coronary artery aneurysm CAA IVIG 

Notes

Acknowledgments

The authors thank Mrs. Arijana Pavelić for her help in the preparation of the manuscript.

Conflict of interest

All the authors hereby declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lorna Stemberger Maric
    • 1
    Email author
  • Ivica Knezovic
    • 1
  • Neven Papic
    • 2
  • Branko Mise
    • 1
    • 3
  • Srdan Roglic
    • 1
  • Leo Markovinovic
    • 1
  • Goran Tesovic
    • 1
    • 3
  1. 1.Clinical Department for Pediatric Infectious DiseasesUniversity Hospital for Infectious ZagrebZagrebCroatia
  2. 2.Department for Viral Hepatitis, ZagrebUniversity Hospital for Infectious DiseasesZagrebCroatia
  3. 3.School of MedicineUnversity of ZagrebZagrebCroatia

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