title: Coagulopathy and platelet activation in Kawasaki syndrome: identification of patients at high risk for development of coronary artery aneurysms.
abstract: Prospective evaluation of platelet activation and hypercoagulability was performed in 31 patients with Kawasaki syndrome. Most patients had elevated acute-phase reactants when studied during the first 3 weeks of their illness; 17 of 25 (68%) patients had factor VIII activity greater than 150%, 18 of 24 (75%) had fibrinogen greater than 400 mg/dl, and 17 of 31 (55%) had a platelet count greater than 450,000/mm3. Antithrombin III was depressed initially in 17 of 25 (68%) patients. Depleted fibrinolytic activity, as measured by a euglobulin lysis time greater than 300 minutes, was documented in nine of 20 (45%) patients. Plasma beta-thromboglobulin (BTG) measured at 0 to 3 weeks was elevated (greater than 43 ng/ml) in seven of 24 (29%) patients. All patients with coronary artery aneurysms had elevated BTG values. The mean BTG in the group with aneurysms was 72.3 ng/ml when measured during the first 3 weeks after onset of fever, and 87.7 ng/ml at 4 to 7 weeks. The group without aneurysms had mean BTG values of 29.4 and 28.3 ng/ml at 0 to 3 and 4 to 7 weeks, respectively. The difference between the two groups was significant (P less than 0.002) for both the initial and later values. An elevated BTG during the first 3 weeks after onset of fever was highly associated with aneurysm formation in our patients (P less than 0.007). No aneurysms occurred in patients with a normal BTG value.
mesh_terms: D000783:Aneurysm / Q000175:diagnosis* / Q000209:etiology; D000990:Antithrombin III / Q000032:analysis; D001791:Blood Platelet Disorders / Q000097:blood* / Q000209:etiology; D001792:Blood Platelets / Q000032:analysis; D002675:Child, Preschool; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000209:etiology; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000150:complications; D012306:Risk; D001620:beta-Thromboglobulin / Q000032:analysis
chemical_list: D001620:beta-Thromboglobulin; D000990:Antithrombin III; D005340:Fibrinogen