Nationwide Survey of Patients With Giant Coronary Aneurysm Secondary to Kawasaki Disease 1999–2010 in Japan

Fukazawa, Ryuji; Kobayashi, Toshimitsu; Mikami, Masashi; Saji, Tsutomu; Hamaoka, Kenji; Kato, Hitoshi; Suzuki, Hiroyuki; Tsuda, Etsuko; Ayusawa, Mamoru; Miura, Masaru; Ebata, Ryota; Kobayashi, T.; Yashiro, Mayumi; Ogawa, Satoshi

doi:10.1253/circj.cj-17-0433

Cited by 57 publications

(51 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3] Currently, KD is a leading cause of acquired heart disease in developed countries. [3][4][5] Fifty years after the first 50 cases reported in 1967, 6 the etiology of KD remains unknown. Japan has the highest incidence rate of KD worldwide.…”

Section: Introductionmentioning

confidence: 99%

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

Kitano

Takeuchi

Suenaga

et al. 2021

Journal of Epidemiology

Self Cite

View full text Add to dashboard Cite

Background: Epidemiological studies show a U-shaped tendency in Kawasaki disease (KD)-related coronary artery abnormalities (CAAs) across age categories. Since studies suggest seasonal variations in KD onset, this study aimed to clarify the epidemiologic features of CAAs, considering the seasons of KD-occurrence. Methods: We analyzed 2,106 (males = 1,215, females = 891) consecutive KD cases from October 1999 through September 2017 using our electronic database of annual surveys, targeting all hospitals with pediatric departments across Wakayama, Japan. The primary outcome was the presence=absence of CAAs measured by echocardiography 1 month after KD onset. Odds ratios (ORs) and 95% confidence intervals (CIs) of combined patient age and sex for CAAs were calculated using logistic regression models adjusted for four seasons. Results: The median age was 25 (range, 1-212) months. The proportion of males decreased with increasing age. The youngest age group (<6 months) showed an inverse summer=autumn to winter=spring ratio (>1.0) in KD-occurrence. CAAs were observed in 2.8% of cases (males = 3.4%, females = 2.1%), which significantly lessened in summer than in other seasons. Moreover, 50% (n = 4=8) of cases with giant aneurysms experienced KD in autumn. Adjusted ORs for CAAs among males aged ≥60 months (3.0; 95%, CI 1.2-7.5) and females aged <6 months (3.6; 95%, CI 1.1-11.8) were significantly higher than those among males aged 12-35 months. Conclusions: Cumulative 18-year data of consecutive KD cases from one area suggest the influence of interactions between patient age and sex on the development of KD-related CAAs. The season of KD-occurrence may reflect the diversity of agents.

show abstract

Section: Introductionmentioning

confidence: 99%

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

Kitano

Takeuchi

Suenaga

et al. 2021

Journal of Epidemiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…KD predominantly affects small- to medium-sized vessels, including coronary arteries (5). If diagnosis is delayed and KD is left untreated, coronary artery lesions may develop in 25% of patients, which, in turn, increases the formation risk of coronary artery aneurysms (CAAs) and, subsequently, can induce coronary artery thrombosis, myocardial infarction or even sudden death (6,7). Intravenous immunoglobulin (IVIG) infusion is an effective, first-line therapy for KD (8).…”

Section: Introductionmentioning

confidence: 99%

Serum exosomal miR‑328, miR‑575, miR‑134 and miR‑671‑5p as potential biomarkers for the diagnosis of Kawasaki disease and the prediction of therapeutic outcomes of intravenous immunoglobulin therapy

2018

View full text Add to dashboard Cite

The present study was conducted to screen serum exosomal microRNAs (miRNAs) for the early diagnosis of Kawasaki disease (KD) and to investigate their underlying mechanisms by analyzing microarray data under accession numbers GSE60965 [exosomal miRNA, including three pooled serum samples from 5 healthy children, 5 patients with KD and 5 patients with KD following intravenous immunoglobulin (IVIG) therapy] and GSE73577 (mRNA, including peripheral blood mononuclear cell samples from 19 patients with KD prior to and following IVIG treatment) from the Gene Expression Omnibus database. Differentially expressed miRNAs (DE-miRNAs) and genes (DEGs) were identified using the Linear Models for Microarray data method, and the mRNA targets of DE-miRNAs were predicted using the miRWalk 2.0 database. The functions of the target genes were analyzed using the Database for Annotation, Visualization and Integrated Discovery (DAVID). As a result, 65 DE-miRNAs were identified with different expression patterns between the healthy children and patients with KD and between patients with KD and patients with KD following IVIG therapy. The target genes of 15 common DE-miRNAs were predicted. Following overlapping the target genes of DE-miRNAs with 355 DEGs, 28 common genes were identified and further screened to construct a network containing 30 miRNA-mRNA regulatory associations. Of these associations, only miR-328-spectrin α, erythrocytic 1, miR-575-cyclic AMP-responsive element-binding protein 5/b-1,4-galactosyltransferase 5/WD repeat and FYVE domain-containing 3/cystatin-A/C-X-C motif chemokine receptor 1/protein phosphatase 1 regulatory subunit 3B, miR-134-acyl-CoA synthetase long chain family member 1/C-type lectin domain family 1 member A and miR-671-5p-tripartite motif containing 25/leucine rich repeat kinase 2/kinesin family member 1B/leucine rich repeat neuronal 1 were involved in the negative regulation of gene expression. Functional analysis indicated that the identified target genes may be associated with inflammation. Accordingly, serum exosomal miR-328, miR-575, miR-134 and miR-671-5p may act as potential biomarkers for the diagnosis of KD and the prediction of outcomes of the IVIG therapy by influencing the expression of inflammatory genes.

show abstract

“…Giant coronary aneurysm has been reported to occur in approximately 0.2% of patients in Japan. 9 In our study, we detected a giant coronary aneurysm in 7 patients (%5.8). Lyskina et al 10 reported a frequency of giant aneurysms of %5.7 in their Russian population.…”

Section: Discussionmentioning

confidence: 50%

“…Therefore, careful monitoring of patients for prevention of coronary thrombosis, and timely surgical intervention are recommended especially within the first 2 years. 9,25 Retrospective design was the main limitation of this study. Several risk factors previously attributed to nonresponse to the therapy could not be investigated due to lack of laboratory and clinical parameters.…”

Section: Discussionmentioning

confidence: 99%

“…The possibility of spontaneous regression of these aneurysms is too low and they may potentially cause coronary stenoses and even myocardial infarction. 9 Giant coronary aneurysms have been reported to be low in countries like Japan where the frequency of KD is high, while the incidence of giant aneurysms has been relatively higher in countries where the KD is less common. 9,10 The aim of our study was to analyze the pediatric patients with KD, to determine the predicting factors of nonresponse to standard therapy and to analyze the patients who had giant coronary aneurysms.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Kawasaki disease in Turkish children: a single center experience with emphasis on intravenous immunoglobulin resistance and giant coronary aneurysms

et al. 2019

View full text Add to dashboard Cite

Prompt diagnosis and the administration of intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery abnormalities (CAA) in Kawasaki Disease (KD). The resistance to treatment and development of the coronary sequelae remain the most important problems in KD. We aimed to determine the predicting factors of nonresponse to initial IVIG therapy and to analyze the cases who had giant coronary aneurysms. A total of 120 KD cases, including 61 children fulfilling the criteria for KD and 59 with incomplete KD were enrolled into this study. Demographic, laboratory, clinical, echocardiographic characteristics, and treatment regimens were reviewed, retrospectively. The median age of the patients was 33.5 months (range: 3-168 months). Coronary artery aneurysms were detected in 35 patients (29%) at the time of diagnosis. Twenty-eight patients had coronary aneurysms small or medium in size, one had a large, and seven had giant coronary aneurysms. CAA persisted in 8 cases in the follow-up, all of which were large or giant aneurysms. A ten month-old girl with a giant coronary aneurysm was referred to coronary bypass surgery in the subacute phase of follow-up, due to myocardial ischemia. Eighteen patients were unresponsive to the initial IVIG therapy (%15), of whom 10 were diagnosed as cKD and 8 were iKD. Patients who did not respond to initial IVIG therapy, had higher white blood cell (WBC) count, higher C-reactive protein (CRP) and lower albumin levels than those who did (P<0.05). In univarite analysis; CRP, WBC and albumin were found to be significant predictors of nonresponse to initial IVIG therapy, while a stepwise multiple linear regression analysis showed that WBC count and albumin levels were significantly correlated with nonresponse to initial treatment with IVIG. Our study showed that WBC count and albumin levels might be used as predictors of nonresponse to the IVIG therapy in Turkish children with KD.

show abstract

Nationwide Survey of Patients With Giant Coronary Aneurysm Secondary to Kawasaki Disease 1999–2010 in Japan

Cited by 57 publications

References 22 publications

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

Serum exosomal miR‑328, miR‑575, miR‑134 and miR‑671‑5p as potential biomarkers for the diagnosis of Kawasaki disease and the prediction of therapeutic outcomes of intravenous immunoglobulin therapy

Kawasaki disease in Turkish children: a single center experience with emphasis on intravenous immunoglobulin resistance and giant coronary aneurysms

Contact Info

Product

Resources

About