title: Cardiac lesions and initial laboratory data in Kawasaki disease: a nationwide survey in Japan.
abstract: BACKGROUND
  Cardiac lesions, such as coronary dilatation, aneurysms, narrowing, myocardial infarction, and valvular lesions, sometimes occur in Kawasaki disease, but most studies have only evaluated cardiac lesions in the later phase of the disease. This study was undertaken to clarify the related factors between cardiac lesions and laboratory data in the initial phase of Kawasaki disease.
  
  
  METHODS
  We conducted a cross-sectional study using data for 26 691 patients from the 22nd nationwide survey of Kawasaki disease in Japan, the observation period of which was from January 2011 through December 2012. We excluded patients with recurrent Kawasaki disease and who were more than seven days from the start of symptoms at admission. We analyzed 23 155 cases (13 353 boys; mean age: 923 ± 734 days) with available laboratory data for white blood cell count, platelet count, serum albumin, and C-reactive protein (CRP).
  
  
  RESULTS
  Cardiac lesions were detected in 984 cases (656 boys and 328 girls); lesions were classified as coronary dilatation (764 cases), coronary aneurysm (40), giant coronary aneurysm (6), coronary narrowing (3), and valvular lesions (204). The significant related factors of initial coronary dilatation were male sex (odds ratio [OR] 1.73), older age (OR per 100 days increase 1.03), higher platelet count (OR per 10 000 cells/µL increase 1.006), lower albumin (OR per 1 g/dL increase 0.66), and higher CRP (OR per 1 mg/dL increase 1.02). The factors related to coronary aneurysm were higher platelet count (OR 1.01) and lower albumin (OR 0.34). No factors were significantly related to giant coronary aneurysm. The related factors of valvular lesions were age (OR 0.98), and higher CRP (OR 1.05).
  
  
  CONCLUSIONS
  Clinicians should consider male sex, older age, higher platelet count, lower albumin levels, and higher CRP levels when assessing risk of cardiac lesions in the initial phase of Kawasaki disease.
authors.affiliation: Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi; Department of Cardiology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Masanari
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yashiro
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kotani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsuboi
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ae
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yanagawa
authors.forename: Tomisaku
authors.initials: T
authors.lastname: Kawasaki
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D007958:Leukocyte Count / Q000706:statistics & numerical data; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000453:epidemiology*; D010976:Platelet Count / Q000706:statistics & numerical data; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein