title: Epidemiology and risk factors for coronary artery abnormalities in children with complete and incomplete Kawasaki disease during a 10-year period.
abstract: Kawasaki disease (KD) is an acute systemic vasculitis of childhood. The diagnosis is based on clinical criteria. However, the presentation of KD is incomplete/atypical for approximately 20 % of patients. Kawasaki disease is complicated with coronary artery lesions (CALs) and considered the most common cause of acquired heart disease in children. The medical records of children discharged with KD from a tertiary pediatric hospital in Athens, Greece, during a decade (2001-2010) were retrospectively analyzed. During the study period, KD was diagnosed for 86 children younger than 14 years of age. Complete diagnostic criteria were fulfilled by 64 of the children (74.4 %), whereas 25.6 % were considered incomplete cases. Cardiovascular complications were detected in 48 children (55.8 %) and CALs in 28 children (32.6 %). The prevalence of CALs did not differ significantly between complete and incomplete/atypical KD (42.2 vs 4.5 %; P = 0.001). Logistic regression analysis showed that erythema in the lips and oral cavity was associated with the development of CALs [odds ratio (OR), 3.03; 95 % confidence interval (CI), 1.051-8.783; P = 0.040]. Conversely, children with incomplete/atypical KD (OR, 0.092; 95 % CI, 0.010-0.816; P = 0.032) and previous antibiotic treatment (OR, 0.17; 95 % CI, 0.036-0.875; P = 0.034) were less likely to experience CALs. Children with an incomplete/atypical presentation of KD or before antibiotic treatment may be at lower risk for the development of CALs. Future multicenter studies may help to establish this association better.
authors: Division of Pediatric Infectious Diseases, First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Levadias Street, 115 26 Athens, Greece.
authors: Georgia
authors: G
authors: Giannouli
authors: Chryssa
authors: C
authors: Tzoumaka-Bakoula
authors: Ioannis
authors: I
authors: Kopsidas
authors: Paraskevi
authors: P
authors: Papadogeorgou
authors: George P
authors: GP
authors: Chrousos
authors: Athanasios
authors: A
authors: Michos
mesh_terms: D002675:Child, Preschool; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors