Prediction of patients with a high risk of coronary artery aneurysm in Kawasaki disease: indication for immunoglobulin therapy.
The prediction of the severity of Kawasaki disease in terms of coronary artery disease is important for the evaluation of prognosis as well as for making decisions on an appropriate form of treatment. Coronary artery lesions develop as early as 8 days after onset of illness and immunoglobulin is known to be ineffective in aneurysms which have already developed. Therefore, we advocate the selection of suitable candidates for immunoglobulin therapy as early as possible after disease onset. Our scoring system is composed of only 3 items which are confined to the results of routine laboratory examinations, and it is desired to be available for use by any hospital offering primary care for patients with Kawasaki disease. However, such a simple procedure may be associated with a reduced level of reliability for evaluation in clinical practice. Early and simple, but reliable, predictors of coronary risk in Kawasaki disease should therefore be further studied in order to reduce the morbidity and mortality through appropriate treatment and care.
Division of Pediatric Cardiology, Shizuoka Children's Hospital, Japan.
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Nakano
D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007116:Immunization, Passive; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors
D001241:Aspirin