Coronary Involvement in Infants with Kawasaki Disease Treated with Intravenous γ-Globulin

Moreno, Noelia; Méndez‐Echevarría, Ana; Arocena, Jaime de Inocencio; Castillo, Fernando del; Baquero-Artigao, Fernando; García-Miguel, Maria Jesús; José, María Isabel de; Aracil, Javier Molina

doi:10.1007/s00246-007-9068-0

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…In addition to the unfavorable laboratory results, in this study, infants ≤6 months had longer days between the disease onset to diagnosis, more incomplete KD, and fewer patients fulfilling the diagnosis criteria within 10 days, which were also risk factors of CAA [24][25][26]32]. In our study, we demonstrated that infants ≤6 months were more vulnerable of having CAA in comparison to those <1 year old [8,10,13,22,31]. Besides that the risk factors of CAA are more in KD's infants younger than 6 months old, the difference of coronary artery anatomy by age might exacerbate the possibility of CAA.…”

Section: Discussionmentioning

confidence: 63%

“…Demographic and laboratory factors were surveyed extensively in previous studies for identifying risk factors of CAA in KD. Demographic factors include male gender [21][22][23], race [22], longer time from fever to treatment [23][24][25], incomplete KD [26], and younger age [9,10,13,[20][21][22]27]. Laboratory factors include lower hemoglobin level [25,28,29], higher platelet count [24,30], higher WBC count [28,29], lower serum albumin [31], and higher alanine aminotransferase [29].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Manifestations Vary with Different Age Spectrums in Infants with Kawasaki Disease

Liu

Hwang

et al. 2012

The Scientific World Journal

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Background. Kawasaki disease (KD) is an acute systemic vasculitis with unknown etiology. The diagnosis of KD depends on clinical manifestations. The prevalence of coronary artery abnormality (CAA) is 11.0% and results in cardiac sequelae, such as myocardial infarction or coronary aneurysm, which are the most serious complications in KD. Methods. We divided KD's children into different age groups: ≤6 months old, 7 months to 1 year old, and >1 year old, respectively. Different parameters were compared in each group. Results. Infants ≤6 months old are less likely to fulfill KD's major diagnostic criteria within 10 days, are prone to develop incomplete KD with the lowest cholesterol level, and have the greatest chance to have CAA and the laboratory features associated with CAA, such as the longest time needed to confirm CA diagnosis, lower hemoglobin level, lower albumin level, and higher platelet count. Infants <1 year old develop higher percentage of leukocytosis and sterile pyuria. But this group has fewer patients with neck lymphadenopathy.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations Vary with Different Age Spectrums in Infants with Kawasaki Disease

Liu

Hwang

et al. 2012

The Scientific World Journal

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“…The rate of CAD is higher in infants than in older children, reaching 24% in a retrospective review [46]. Risk factors for IVIG resistance include age less than 1 year, male sex, high neutrophil count, low platelet count, high CRP, and high liver enzymes [45][46][47][48]. IVIG nonresponders have higher risk of coronary aneurysms and giant coronary aneurysms than those whose fever is controlled with IVIG [47].…”

Section: Kawasaki Diseasementioning

confidence: 98%

“…Despite the routine use of IVIG and aspirin in Kawasaki disease, coronary artery disease (CAD) affects 10-20% of patients [45]. The rate of CAD is higher in infants than in older children, reaching 24% in a retrospective review [46]. Risk factors for IVIG resistance include age less than 1 year, male sex, high neutrophil count, low platelet count, high CRP, and high liver enzymes [45][46][47][48].…”

Section: Kawasaki Diseasementioning

confidence: 99%

Progress in pediatric vasculitis

O’Neil

2009

Current Opinion in Rheumatology

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“…Un diagnóstico oportuno y un tratamiento adecuado durante la fase aguda de la enfermedad disminuyen el riesgo de coronariopatía. El uso de gammaglobulina parenteral en los primeros 10 días de la enfermedad disminuye este riesgo de un 20% a un 5-2% 4,5 .…”

Section: Introductionunclassified

Afección coronaria en niños con enfermedad de Kawasaki

Battagliotti

Karakachoff

González

et al. 2013

Rev. Argent. Reumatol.

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Objetivo: La enfermedad de Kawasaki (EK) es una vasculitis frecuente en la infancia que puede producir aneurismas coronarios. Con el objetivo de describir las lesiones coronarias tanto en fase aguda como al año del diagnóstico, realizamos este estudio retrospectivo de 30 niños de 0 a 7 años con EK atendidos en nuestro centro, desde enero de 1990 a febrero de 2010. Resultados: Presentaron afección coronaria 7 pacientes. Cuatro de ellos varones. El 71,4% (n: 5) tenían EK completo. La edad media de inicio de los síntomas fue de 1,55 años (rango: 0,083-3). La mayoría de las lesiones fueron menores tales como la ectasia difusa o el aneurisma pequeño de ambas coronarias (n: 5). Estables al año de seguimiento. Dos varones de 19 días y 7 meses de edad presentaron lesiones mayores que correspondieron a los aneurismas múltiples y un aneurisma gigante persistente. La duración de la fiebre (p=0,04) y el retraso de aplicación de la gammaglobulina (p=0,025) pudo asociarse con afección coronaria. Conclusión: Alto índice de coronariopatías. La mayoría de las lesiones fueron menores tales como las ectasias difusas o los aneurismas pequeños estables al año de evolución. Las lesiones mayores correspondieron a los aneurismas múltiples y un aneurisma gigante persistente. La duración de la fiebre y el retraso en el tratamiento se asoció con mayor compromiso coronario. Recomendamos al médico mantener un alto índice de sospecha de esta enfermedad particularmente en los niños menores de un año de vida.

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Coronary Involvement in Infants with Kawasaki Disease Treated with Intravenous γ-Globulin

Abstract: In spite of the exclusion of our study of incomplete presentations and of an early administration of IVIG in our patients, we have observed a high rate of infants who developed CAD, which is similar to the one reported in children who do not receive IVIG.

Cited by 10 publications

References 16 publications

Clinical Manifestations Vary with Different Age Spectrums in Infants with Kawasaki Disease

Clinical Manifestations Vary with Different Age Spectrums in Infants with Kawasaki Disease

Progress in pediatric vasculitis

Afección coronaria en niños con enfermedad de Kawasaki

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