Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience
- 455 Downloads
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.
KeywordsKawasaki disease Incomplete Kawasaki disease Coronary artery aneurysm CAA IVIG
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.
- 3.Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA, Committee on Rheumatic Fever E, Kawasaki Disease CoCDitYAHA (2004) Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young. American Heart Association. Pediatrics 114(6):1708–1733. doi: 10.1542/peds.2004-2182 Google Scholar
- 4.Giannouli G, Tzoumaka-Bakoula C, Kopsidas I, Papadogeorgou P, Chrousos GP, Michos A (2013) Epidemiology and risk factors for coronary artery abnormalities in children with complete and incomplete Kawasaki disease during a 10-year period. Pediatr Cardiol 34(6):1476–1481. doi: 10.1007/s00246-013-0673-9 CrossRefPubMedGoogle Scholar
- 7.Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodo X, Uehara R, Burgner D, Bainto E, Pierce D, Tyree M, Cayan D, Kawasaki Disease Global Climate C (2013) Seasonality of Kawasaki disease: a global perspective. PloS One 8(9):e74529. doi: 10.1371/journal.pone.0074529 CrossRefPubMedCentralPubMedGoogle Scholar
- 9.Gorczyca D, Postepski J, Olesinska E, Lubieniecka M, Lachor-Motyka I, Opoka-Winiarska V, Gruenpeter A (2014) The clinical profile of Kawasaki disease of children from three Polish centers: a retrospective study. Rheumatol Int 34(6):875–880. doi: 10.1007/s00296-013-2836-7 CrossRefPubMedCentralPubMedGoogle Scholar
- 10.Lin YT, Manlhiot C, Ching JC, Han RK, Nield LE, Dillenburg R, Pepelassis D, Lai LS, Smythe JF, Chahal N, Yeung RS, McCrindle BW (2010) Repeated systematic surveillance of Kawasaki disease in Ontario from 1995 to 2006. Pediatr Int 52(5):699–706. doi: 10.1111/j.1442-200X.2010.03092.x CrossRefPubMedGoogle Scholar
- 16.Yellen ES, Gauvreau K, Takahashi M, Burns JC, Shulman S, Baker AL, Innocentini N, Zambetti C, Pancheri JM, Ostrow A, Frazer JR, Sundel RP, Fulton DR, Newburger JW (2010) Performance of 2004 American Heart Association recommendations for treatment of Kawasaki disease. Pediatrics 125(2):e234–e241. doi: 10.1542/peds.2009-0606 CrossRefPubMedCentralPubMedGoogle Scholar
- 17.Patel A, Holman RC, Callinan LS, Sreenivasan N, Schonberger LB, Fischer TK, Belay ED (2013) Evaluation of clinical characteristics of Kawasaki syndrome and risk factors for coronary artery abnormalities among children in Denmark. Acta Paediatr 102(4):385–390. doi: 10.1111/apa.12142 CrossRefPubMedGoogle Scholar