Coagulopathy and platelet activation in Kawasaki syndrome: Identification of patients at high risk for development of coronary artery aneurysms

Burns, Jane C.; Glodé, Mary P.; Clarke, Susan H.; Wiggins, James W.; Hathaway, William E.

doi:10.1016/s0022-3476(84)80114-6

Cited by 128 publications

(69 citation statements)

References 17 publications

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“…In contrast, erythrocyte sedimentation rate (ESR) on admission was not significantly different. Platelet counts of Ͼ450 000/mm 3 were found significantly more often in the patients in the DDG.…”

Section: Patient Characteristicsmentioning

confidence: 85%

“…There have been 3 outbreaks in Colorado investigated by the Centers for Disease Control and Prevention in the last 20 years, and physicians throughout the state have aided in these investigations. 3,8,9 The Children's Hospital (Denver) is a large tertiary care pediatric hospital, and our infectious-disease group routinely takes calls from providers throughout the state for questions and referrals related to KS. Questions regarding KS are one of our most common telephone inquiries, indicating that KS is often considered in the differential diagnosis of febrile children.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The etiology of this serious disease remains unknown, and there is no laboratory test to identify affected children reliably. Diagnosis of this disease is made by recognition of clinical signs consistent with the KS diagnostic criteria and excluding other diseases.…”

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confidence: 99%

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Delayed Diagnosis of Kawasaki Syndrome: An Analysis of the Problem

2005

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ABSTRACT.Objective. Most pediatric providers in Colorado are familiar with Kawasaki syndrome (KS). However, in a recent outbreak, 30% of cases were diagnosed after illness day 10. We hypothesized that these children saw providers who were not familiar with KS, were given antibiotics for other diagnoses that delayed identification, had access-to-care issues, or presented atypically.Methods. A retrospective chart review of 106 consecutive KS cases seen at the Children's Hospital in Denver during 1994 -2000 was conducted.Results. Twenty-five of 106 children (23.6%) were diagnosed after day 10 of illness (delayed-diagnosis group [DDG]), and these 25 cases were compared with 81 cases diagnosed on or before day 10 (early-diagnosis group [EDG]). There were no differences between patients in the DDG and EDG in age, gender, number of visits, specialty of the primary care physician, time to the first medical visit, number of antibiotics received, coronary artery abnormalities, white blood cell count, or erythrocyte sedimentation rate. Patients in the DDG had significantly more days of fever, rash, red eyes, and oral changes. A platelet count of >450 000/mm 3 occurred more often in the DDG (56%) than the EDG (30%). After additional analysis, patients in the EDG had close clustering of symptom onset in the first few days of illness, but patients in the DDG had onset of symptoms scattered over 9 days. Patients in the DDG were 2.8 times more likely to have coronary artery aneurysms than patients in the EDG (DDG: 24%; EDG: 8.6%).Conclusions. Diagnosis after the 10th day of illness was not linked to type of medical provider, number of antibiotics received, or number of physician visits. Patients in the DDG exhibited the typical features of KS, but the onset of their symptoms was dispersed over time as opposed to the close clustering of symptoms in the EDG. Because coronary artery aneurysms occurred significantly more often in the patients in the DDG, more education is needed to teach health care providers to have a high index of suspicion for KS in young children presenting with fever/rash illnesses.

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Section: Patient Characteristicsmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Delayed Diagnosis of Kawasaki Syndrome: An Analysis of the Problem

2005

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“…[43][44][45][46] La tasa de mortalidad estandarizada en Japón es 1,25 para la EK y 2,35 cuando se asocia compromiso coronario. 47 El pico de mortalidad ocurre de 15 a 45 días desde el inicio de la fiebre; 48 la muerte súbita secundaria a IAM puede suceder varios años después en individuos con aneurismas o estenosis.…”

Section: Factores Predictores De Enfermedad Coronariaunclassified

Enfermedad de Kawasaki: Consenso interdisciplinario e intersociedades

2016

Arch Argent Pediat

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“…It was suggested that endothelial cell damage due to coronary vasculitis is likely the trigger for platelet activation (12). Also, a hypercoagulable state with depleted fibrinolytic activity has been found in the majority of children with Kawasaki disease (13). In addition, the turbulent flow occurs within the lumen of coronary aneurysms (14).…”

Section: Introductionmentioning

confidence: 99%

Kawasaki Disease Complicated by Acute Myocardial Infarction Due to Thrombotic Occlusion of Coronary Aneurysms 19 Years after Onset.

et al. 1992

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A 25-year-old man with a history of Kawasaki disease from the age of 7 had acute inferior myocardial infarction. Emergency right coronary arteriogram showed successive coronary aneurysms at the proximal to middle portion of the right coronary artery, and total occlusion at the proximal segment. Intracoronary thrombolysis was performed and the right coronary artery was recanalized. On left coronary arteriography, coronary aneurysms and mild localized stenoses at the inlet and outlet of the aneurysms were found. It was suggested that the myocardial infarction was caused by thrombotic occlusion of coronary aneurysms complicated with Kawasaki disease. (Internal Medicine 31: 774-777, 1992)

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Coagulopathy and platelet activation in Kawasaki syndrome: Identification of patients at high risk for development of coronary artery aneurysms

Cited by 128 publications

References 17 publications

Delayed Diagnosis of Kawasaki Syndrome: An Analysis of the Problem

Delayed Diagnosis of Kawasaki Syndrome: An Analysis of the Problem

Enfermedad de Kawasaki: Consenso interdisciplinario e intersociedades

Kawasaki Disease Complicated by Acute Myocardial Infarction Due to Thrombotic Occlusion of Coronary Aneurysms 19 Years after Onset.

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