title: Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience.
abstract: Kawasaki disease (KD) is an acute systemic vasculitis of childhood. Due to development of coronary artery aneurysms (CAA) it is considered the most common cause of acquired heart disease in children. The clinical and laboratory features of patients with complete and incomplete KD were compared in order to identify the possible predictors of CAA development. A cross-sectional study of children with KD treated at the University Hospital for Infectious Diseases, Zagreb, between January 2003 and December 2012 was conducted. A total of 111 KD patients were included; 70.3% patients had complete KD. Patients with complete KD had more frequently rash, changes on extremities and mucous membranes, as well as higher serum bilirubin, aminotransferases, gamma-glutamyl transferase and lactate dehydrogenase levels. Patients with incomplete KD had longer duration of fever before the diagnosis (8 vs. 7 days) and delayed IVIG treatment (day 8 vs. 7). CAA was detected in seven children (6.3%). Disease duration before hospitalization >6 days (OR 7.16, 95% CI 1.51-100.35), age <6 months (OR 25.86, 95% CI 1.68-398.35) and platelet count >771 after the 7th day of disease (OR 13.33, 95% CI 2.19-80.87) were independently associated with CAA development. The diagnosis and treatment in incomplete KD can be delayed due to the absence of major criteria. Age, duration of symptoms prior hospitalization and platelet count were identified as independent predictors of CAA development.
authors.affiliation: Clinical Department for Pediatric Infectious Diseases, University Hospital for Infectious Zagreb, Mirogojska 8, 10 000, Zagreb, Croatia, lorna_stemberger@yahoo.com.
authors.forename: Lorna Stemberger
authors.initials: LS
authors.lastname: Maric
authors.forename: Ivica
authors.initials: I
authors.lastname: Knezovic
authors.forename: Neven
authors.initials: N
authors.lastname: Papic
authors.forename: Branko
authors.initials: B
authors.lastname: Mise
authors.forename: Srdan
authors.initials: S
authors.lastname: Roglic
authors.forename: Leo
authors.initials: L
authors.lastname: Markovinovic
authors.forename: Goran
authors.initials: G
authors.lastname: Tesovic
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D017523:Croatia; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010976:Platelet Count; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D061665:Time-to-Treatment
chemical_list: D016756:Immunoglobulins, Intravenous