Can Coronary Artery Involvement in Kawasaki Disease be Predicted?

Coronary artery involvement is seen in approximately 15-20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for...

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Bibliographic Details
Published in:Diagnostics (Basel) 2013-03, Vol.3 (2), p.232-243
Main Authors: Ghelani, Sunil J, Kwatra, Neha S, Spurney, Christopher F
Format: Article
Language:English
Subjects:
Coronary vessels
Erythrocytes
Kawasaki disease
Lymphatic system
muco-cutaneous lymph node syndrome
Review
vasculitis
Vein & artery diseases
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Summary:Coronary artery involvement is seen in approximately 15-20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature. A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High erythrocyte sedimentation rate and refractory Kawasaki disease were found to be independent predictors of coronary artery involvement. Review of literature suggested a wide range of coronary involvement (60%), and highly conflicting clinical and laboratory associations. It remains difficult to accurately determine risk of coronary artery involvement, although some laboratory markers may provide information that is helpful for parental counseling and clinical follow up. Future identification of novel biomarkers and host predispositions may further our understanding of coronary artery risks and help personalize therapy for Kawasaki disease.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics3020232