Giant aneurysms: A gender-specific complication of Kawasaki disease?

Dietz, Sanne M.; Kuipers, Irene M.; Tacke, Carline E.; Koole, Jeffrey C D; Hutten, Barbara A.; Kuijpers, Taco W.

doi:10.1016/j.jjcc.2016.12.014

Cited by 10 publications

(5 citation statements)

References 23 publications

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“…In the present study, we found that male patients with CAA and the rs7251246 CC genotype had a significantly higher risk of thrombosis than children with the CT/TT genotype. This result may be attributed to male patients being more genetically susceptible to CAA and thrombotic events ( 35 , 36 ). As low-dose aspirin alone is not sufficient to prevent CAA thrombosis ( 37 – 39 ), the AHA recommends dual antiplatelet therapy as prophylaxis for patients at high risk ( 3 ); hence, dual antiplatelet therapy is recommended for male children with the CC genotype of rs7251246 to prevent thrombosis because the medical management of such patients depends on the judicious use of thromboprophylaxis.…”

Section: Discussionmentioning

confidence: 99%

ITPKC polymorphism (rs7251246 T > C), coronary artery aneurysms, and thrombosis in patients with Kawasaki disease in a Southern Han Chinese population

et al. 2023

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ObjectivesKawasaki disease (KD) is a commonly acquired pediatric systemic vasculitis disease resulting in coronary artery aneurysm (CAA). The relationship between the ITPKC polymorphism (rs7251246) and the severity and susceptibility to KD in the Han Chinese population in Southern China remains unclear.MethodsWe enrolled 262 children as controls and 221 children with KD (46 [20.8%] with intravenous immunoglobulin resistance and 82 [37.1%] with CAA). The relationship between the ITPKC rs7251246 polymorphism, KD susceptibility, and CAA formation was investigated.ResultsWhile the ITPKC rs7251246 T>C polymorphism was not significantly associated with KD susceptibility, it was significantly related to the CAA risk in children with KD [CC/CT vs. TT: adjusted odds ratio [OR] 2.089, 95% confidence interval [CI] 1.085–4.020]. Male children with the rs7251246 CT/TT genotype had a significantly lower risk of thrombosis [CT/TT vs. CC: adjusted OR 0.251, 95% CI 0.068–0.923]. Children with KD, especially those with CAA, had significantly downregulated ITPKC mRNA compared to healthy children. ITPKC mRNA levels were lower in children with CAA who developed thrombosis (P=0.039). In children with KD, the CC genotype showed lower mRNA levels of ITPKC (P=0.035).ConclusionThe ITPKC rs7251246 T>C polymorphism may be a risk factor for CAA and thrombosis in children with KD in the Han Chinese population, likely due to differences in mature mRNA levels caused by interference of RNA splicing. Dual antiplatelet therapy for thrombosis is recommended for male children with the rs7251246 CC genotype.

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Section: Discussionmentioning

confidence: 99%

ITPKC polymorphism (rs7251246 T > C), coronary artery aneurysms, and thrombosis in patients with Kawasaki disease in a Southern Han Chinese population

et al. 2023

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“…Previous studies have shown that sex plays an important role in the occurrence of CAA ( 31 , 32 ). Therefore, a separate statistical analysis was carried out on different sexes.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

Sun

et al. 2022

Front. Cardiovasc. Med.

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BackgroundKawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology that occurs during early childhood, commonly involving the coronary artery, and can lead to coronary artery aneurysms (CAAs).MethodsThe demographic, clinical, and laboratory data of KD patients without coronary artery lesions (N-CAL) and with CAA were collected during 2005–2020 at the Second Affiliated Hospital of Wenzhou Medical University. The patients were divided into the development cohort and the validation cohort. First, we compared the general information, symptoms, and laboratory data of N-CAL and CAA patients in the development cohort and the total cohort and screened out the different indices by logistic regression analysis. Then, we established three models and compared the area under the curve (AUC) values of the receiver operating characteristic (ROC) curves to identify meaningful models for CAA, which were further verified by decision curve analysis (DCA). Second, taking into account previous reports on the importance of gender to CAA, gender stratification was conducted.ResultsThe analysis of clinical and blood indices revealed the following novel features: (i) Many factors were found to be related to CAA, including IVIG resistance and the symptoms of rash, oral changes, and cervical lymphadenopathy. (ii) The development cohort was analyzed by logistic regression, and three models were established. The ROC curves showed that Model 2, composed of IVIG resistance, rash, oral changes, and cervical lymphadenopathy, had a better AUC value and easily to evaluate in the prediction of CAA. (iii) The selected model for predicting CAA in the development cohort was further confirmed in the validation cohort through DCAs. (iv)We further compared the items enrolled in the three models above between the N-CAL and CAA groups by sex, and the results indicated that female KD patients without rash, oral changes, and cervical lymphadenopathy were more likely to develop CAA.ConclusionThe absence of rash, oral changes, and cervical lymphadenopathy are risk factors for CAA, especially in female KD patients. Accurately recognizing symptoms, early diagnosis, and standard treatment for KD are key to reducing the incidence of CAA.

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“…Also, lots of studies evaluated the relationship between sexes and disease complications. Some of them resulted in a higher risk of complications in male patients [ 15 , 16 ]. Contrary to these, we found no statistically significant sex-specific risk for dilation and aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of children diagnosed with Kawasaki disease

VAROL,

DEDEOĞLU,

KILIÇ

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim The aim of our study was to evaluate the long-term impacts of Kawasaki disease on our patients regarding coronary involvement demographic characteristics, treatment regimens, and clinical course. Materials and methods Our study included 104 patients diagnosed and hospitalized with Kawasaki disease in our center, from January 2004 to January 2019. In our study, patients were divided into three groups according to coronary artery involvement. Patients in group 1 had no echocardiographic findings, while the ones in group 2 had coronary artery dilatation and ones in group 3 had coronary artery aneurysm (CAA). Results Among 104 patients, the median age was 9.15 (3.0–22.0) years, and 61 of the patients were male while 43 of the patients were female. With a wide range of 1.50–16.50 years of follow-up time, the median diagnosis age of our patients was 31 months (3.0–164.0). Fever duration (median day 10 (5–21), p = 0.025) was statistically significantly higher in group 3. Blood C-reactive protein (CRP) levels, white blood cell (WBC) counts, and neutrophil counts were significantly higher in group 3. There was a statistically significant difference between patients in group 3 and group 2 in which the lowest strain deformation values were in the patients of group 3. In contrast to group 1, the time for initiation of IVIG therapy is significantly prolonged both in group 2 (median: 9.5 days, p = 0.028) and group 3 (median: 10 days, p = 0.036). Conclusion In our study, serum CRP levels, WBC count, and neutrophil count were higher in patients with coronary artery abnormalities, in agreement with the previous studies. In the light of our results, we consider that the most important determining factor for the development of coronary artery aneurysm is the time of intravenous immunoglobulin (IVIG) administration.

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Giant aneurysms: A gender-specific complication of Kawasaki disease?

Cited by 10 publications

References 23 publications

ITPKC polymorphism (rs7251246 T > C), coronary artery aneurysms, and thrombosis in patients with Kawasaki disease in a Southern Han Chinese population

ITPKC polymorphism (rs7251246 T > C), coronary artery aneurysms, and thrombosis in patients with Kawasaki disease in a Southern Han Chinese population

The Significance of Symptoms in Predicting Coronary Artery Aneurysms of Kawasaki Disease, Especially in Female Patients

Retrospective analysis of children diagnosed with Kawasaki disease

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