European Journal of Pediatrics

, Volume 172, Issue 12, pp 1641–1647

Clinical features of recurrent Kawasaki disease and its risk factors

Original Article

Abstract

The clinical features and risk factors for recurrence of Kawasaki disease (KD) remain unclear. In order to summarize clinical features of recurrent KD and identify risk factors associated with recurrence, we conducted a retrospective review of the medical records of consecutive cases of KD from January 2002 to December 2010. Demographic, clinical, laboratory, and echocardiographic data were analyzed. The maximum coronary artery Z score normalized against body surface area was assessed using coronary artery diameters. At the first onset of recurrent KD, children had longer durations of fever before intravenous immunoglobulin (IVIG) treatment and higher levels of alanine aminotransferase, serum aspartate aminotransferase (AST), and lower hemoglobin levels than those with a single episode of KD. Multivariate logistic regression analysis showed that long durations of fever before IVIG treatment, high AST levels, and reduced hemoglobin levels were significantly associated with recurrent KD. Ten of the 22 recurrent KD children had coronary artery complications during the first onset episode, and six (60 %) of these also had coronary artery complications during the recurrence. Children with longer durations of fever, lower hemoglobin levels, and higher AST levels may be at increased risk for KD and coronary artery complications are more likely to occur in children with recurrent KD if they were present during the first episode.

Keywords

Kawasaki disease Recurrence Risk factors Z score 

Abbreviations

AST

Serum aspartate aminotransferase

ALT

Alanine aminotransferase

BSA

Body surface area

CRP

C-reactive protein

CI

Confidence interval

ESR

Erythrocyte sedimentation rate

IVIG

Intravenous immunoglobulin

KD

Kawasaki disease

LMCA

Left main coronary artery

LAD

Left anterior descending coronary artery

OR

Odds ratio

RCA

Right coronary artery

WBC

White blood cell count

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Cardiology, Beijing Children’s HospitalCapital Medical UniversityBeijingChina

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