Clinical relevance of the risk factors for coronary artery lesions in Kawasaki disease

Abstract

We aimed to investigate which factors are associated with coronary artery lesions (CALs) during the acute and chronic stages in Taiwanese children with Kawasaki disease (KD). A total of 216 children with KD were enrolled. Clinical and laboratory data were obtained for each child within 7 days of illness. The patients were classified into KD children without acute CALs (n=135) and those with acute CALs (n=81) according to echocardiography data at Week 2 after treatment. Then, KD children with acute CALs were further divided into those without chronic CALs (n=55) and with chronic CALs (n=26) according to annual echocardiography data. During acute stage of KD, neutrophil count (<54%) [odds ratio (OR)=0.44, p=0.041]; second dose of intravenous immunoglobulin (IVIG) treatment (OR=5.01, p=0.009); and platelet count (≤400,000) (OR=0.42, p=0.006) were correlated with the risk of acute CALs. During chronic stage of KD, age (12-60 months) (OR=0.25, p=0.042); first dose of IVIG treatment (OR=0.12, p=0.005); and band count (≥3%) (OR=3.51, p=0.032) were correlated with the risk of chronic CALs. Our results suggest that the effects of neutrophil count, doses of IVIG treatment, and platelet count on CALs in acute KD are important. Age, doses of IVIG treatment, and band count are related to the persistence of CALs in chronic stage of KD.

Kawasaki disease in children and adolescents: clinical data of Kawasaki patients in a western region (Tyrol) of Austria from 2003–2012

“…Many studies were done to predict the risk of cardiac involvement in KD [27–29]. In addition to young age [8], duration of fever (presumably reflecting the severity of ongoing vasculitis) has been confirmed as a powerful predictor of coronary artery aneurysms in various studies [30].…”

“…An investigation in Taiwan showed that the effects of neutrophil count, dosage of IVIG treatment, and platelet count (<400 000) in acute coronary artery lesions in KD are important whereas age, dose of IVIG treatment and band count are related to the persistence of coronary lesions in chronic stage [27, 33]. Besides the dose of IVIG also the differences in the manufacturing process such as purification, preservation and the IgA content may influence the effectiveness of prevention of coronary complications [34].…”

Myeloperoxidase genetic polymorphisms and susceptibility to Kawasaki disease in Taiwanese children

“…22 Neutrophil activation has been suggested to play an important role in KD pathogenesis. 23,24 In this series, the significant association between neutrophil number and acute CALs in KD patients provides partial evidence of the involvement of neutrophils in the pathogenesis of KD. The effect of MPO in vasculitis might be related to direct production of ROS, facilitation of neutrophil priming or activation, elevation of extracellular proteolytic activity, or contribution to endothelial dysfunction.…”

High Efficiency of Human Normal Immunoglobulin for Intravenous Administration in a Patient with Kawasaki Syndrome Diagnosed in the Later Stages

“…Более 20 рандомизированных исследований доказывают эффективность ВВИГ у пациентов с болезнью Кавасаки. При своевременном назначении иммуноглобулина (до развития коронарита) можно предотвратить развитие коронарных аневризм, изменить прогноз заболевания, снизить риск развития жизнеугрожающих осложнений [8].…”