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The factors affecting the disease course in Kawasaki disease

  • Cohort Studies
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Abstract

The aim of this study was to review the characteristics of patients with Kawasaki disease (KD) from Turkey and to assess the performance of the Kobayashi score (KS), Harada score (HS), Formosa score (FS), Egami score (ES) and other parameters in predicting intravenous immunoglobulin (IVIG) resistance and coronary artery involvement (CAI) in the Turkish population. Patients who were diagnosed as being in the acute phase of KD at Hacettepe University Faculty of Medicine (Ankara, Turkey) between June 2007 and January 2016 reviewed retrospectively, and those between January 2016 and February 2018 reviewed prospectively, were included in this cohort study. A total of 100 patients with KD were included in this study. Statistical Package for Social Sciences for Windows 22.0 (SPSS Inc, Chicago, IL, USA) was used for statistical analysis. Eighty-five patients (85%) responded to IVIG treatment, whereas 15 (5 female, 10 male) were IVIG resistant. CAI was detected in echocardiography at diagnosis in 31 (31%) (9 female; 22 male) patients. For predicting IVIG resistance, KS, ES, FS, and HS had sensitivity of 82.1%, 26.7%, 30.8%, 69.2% and specificity of 35.7%, 94%, 51.2%, 45.8%, respectively. For the association with CAI occurrence, the sensitivities were 17.2%, 3.3%, 35.7%, 70.4% and the specificities were 78.5%, 88.4%, 49.3%, 49.3% for the aforementioned scores, respectively. The multivariate analysis showed white blood cell (WBC) count [Odd’s ratio (OR) 4.1; 95% confidence interval (CI) 1.26–13.23; p = 0.019] and hematocrit (OR 3.8; 95% CI 1.15–12.4; p = 0.028), as independent predictors of CAI while gamma-glutamyl transferase (GGT) level (OR 5.7; 95% CI 1.73–27.51; p = 0.018) was detected as the only independent predictor of IVIG resistance. This is the first study from Turkey in KD to evaluate the association of the scoring systems for IVIG resistance and CAI. The risk scoring systems in KD did not predict the risk for IVIG resistance and were not associated with CAI in Turkish population.

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Abbreviations

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

CAI:

Coronary artery involvement

CRP:

C-reactive protein

ES:

Egami score

ESR:

Erythrocyte sedimentation rate

FS:

Formosa score

GGT:

Gamma-glutamyl transferase

HS:

Harada score

IL:

Interleukin

IVIG:

Intravenous immunoglobulin

IQR:

Interquartile range

KD:

Kawasaki disease

KS:

Kobayashi score

MP:

Methylprednisolone

OR:

Odd’s ratio

ROC:

Receiver operating characteristic

SPSS:

Statistical Package for Social Sciences

WBC:

White blood cell

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Elif Arslanoglu Aydin

  2. Department of Pediatric Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Ilker Ertugrul & Dursun Alehan

  3. Department of Pediatric Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Yelda Bilginer, Ezgi Deniz Batu, Hafize Emine Sonmez, Selcan Demir, Zehra Serap Arici, Erdal Sag & Seza Ozen

Authors
  1. Elif Arslanoglu Aydin
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  4. Ezgi Deniz Batu
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  8. Erdal Sag
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Contributions

Manuscript EAA; literature search EAA, EDB, SO; figure EAA, SO; study desing EAA, SO; data collection EAA, EDB, HES, SD, ZSA, ES, İE, DA, YB, SO; data analysis EAA, SO; data interpretation EAA, YB, SO; writing EAA, EDB, SO. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seza Ozen.

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Conflict of interest

The authors declare no conflict of interest.

Research involving human participants and/or animals

When the patients admitted to the hospital, the parents gave a general consent approving anonymous data use for academic purpose.

Informed consent

The written consents from the patient families were obtained according to the Declaration of Helsinki (1964) and the study was approved by the ethics committee of Hacettepe University (GO-16/45-15; approval date, 1st March 2016).

Ethics approval and consent to participate

The written consents from the patient families were obtained according to the Declaration of Helsinki (1964) and the study was approved by the ethics committee of Hacettepe University (GO-16/45-15; approval date, 1st March 2016).

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Arslanoglu Aydin, E., Ertugrul, I., Bilginer, Y. et al. The factors affecting the disease course in Kawasaki disease. Rheumatol Int 39, 1343–1349 (2019). https://doi.org/10.1007/s00296-019-04336-2

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