Six principal symptoms and coronary artery sequelae in Kawasaki disease.
BACKGROUND
The relationship between coronary artery sequelae due to Kawasaki disease and the six principal symptoms associated with the latter are still unknown.


METHODS
Among the 16,952 patients reported in the 17th nationwide survey on Kawasaki disease, 14,068 were found to have definite and typical cases with five or six principal symptoms. The proportions of coronary artery aneurysms including dilatation of the artery were compared between the patient group with six symptoms and that with five.


RESULTS
Percentages for those with all six symptoms (7223) were 4.7% for coronary dilatations (i.e. small aneurysms), 1.7% for coronary aneurysms (i.e. middle-sized aneurysms), and 0.42% for giant coronary aneurysms (i.e. large aneurysms) 1 month after onset, whereas for those with five symptoms (6,845), the corresponding percentages were 4.1%, 1.4%, and 0.22%, respectively. For overall observation, the odds ratios were 1.44, 1.28, and 1.70 for the three types of aneurysm, respectively. For male patients, all the odds ratios were >1.0, and some were significant. In contrast, odds ratios <1.0 were observed among those with six symptoms in some subgroups among female patients despite the lack of significance.


CONCLUSIONS
Because odds ratios were elevated - especially for male patients with Kawasaki disease - with all six principal symptoms, patients with the six symptoms are more problematic for coronary sequelae among the definite cases, although there was not a specific symptom for the sequelae.
Nakamura
Yosikazu
Y
Department of Public Health, Jichi Medical University, Shimotsuke, Japan. nakamuyk@jichi.ac.jp
Yashiro
Mayumi
M
Sadakane
Atsuko
A
Aoyama
Yasuko
Y
Oki
Izumi
I
Uehara
Ritei
R
Yanagawa
Hiroshi
H
D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003323:Coronary Aneurysm / Q000453:epidemiology* / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index