Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease

Nakamura, Yosikazu; Yashiro, Mayumi; Uehara, Ritei; Watanabe, Makoto; Tajimi, Morihiro; Oki, Izumi; Ojima, Toshiyuki; Sonobe, Tomoyoshi; Yanagawa, Hiroshi

doi:10.1111/j.1442-200x.2004.01840.x

Cited by 69 publications

(38 citation statements)

References 8 publications

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“…It is known that patients with KD also frequently develop hyponatremia [4,7,10]. Our present study disclosed that the prevalence of hyponatremia is nearly one third of the patients with KD, which is in agreement with the previous reports [4,10].…”

Section: Discussionsupporting

confidence: 95%

Immunoglobulin preparations affect hyponatremia in Kawasaki disease

et al. 2010

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Hyponatremia frequently occurs in Kawasaki disease (KD). The aim of this study was to investigate the effect of Na content of the intravenous immunoglobulin (IVIG) preparation on serum Na levels in KD. Seventy-eight subjects, of whom 27 had hyponatremia, were split up into two groups: group A receiving IVIG preparations containing high Na (0.9%) and group B receiving IVIG preparations containing trace Na. While the data before IVIG therapy revealed no significant differences in the median serum Na between the groups, an administration of IVIG preparations increased the serum levels of Na in group A (P < 0.01) but not in group B (P > 0.05). Furthermore, the median serum Na level was significantly higher in group A than that in group B (139.0 vs 137.0 mEq/L, respectively, P < 0.01). No significant difference was found in the prevalence of coronary artery lesions between the groups. In conclusion, we should keep it in mind that the IVIG products without Na have an adverse affect on hyponatremia in KD though their efficacy seems to be equivalent to those containing high Na.

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Section: Discussionsupporting

confidence: 95%

Immunoglobulin preparations affect hyponatremia in Kawasaki disease

et al. 2010

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“…They also cited that the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in KD has sometimes been reported, and cerebral vasculitis is thought to be the etiology of SIADH in KD. Nakamura et al [2] also recently reported that hyponatremia at the patient's first visit to hospital might be a predictor of giant coronary aneurysm (>8 mm), which was not mentioned in Watanabe et al's study. Nakamura et al speculated that the relationship between hyponatremia and giant coronary aneurysms is based on the permeability of the endothelium, severity of the illness, dehydration, duration of period with fever, and so forth [2].…”

Section: Sirsmentioning

confidence: 87%

Kawasaki disease and hyponatremia

et al. 2006

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“…The Harada score, designed to identify the severely affected individuals who need intravenous gamma-globulin (IVGG) therapy, suggests that leukocytosis more than 12,000/mm 3 , platelets less than 350,000/mm 3 , semi-quantitative CRP more than 3+, hematocrit less than 35%, albumin less than 3.5 g/dL, age less than 12 months and male gender are risk factors [7]. Fever duration prior to treatment and an initial sodium concentration of less than 135 mEq/L have also been suggested to be risk factors of CAA [8,17]. In addition, low serum albumin has been reported as a risk factor in multiple studies [8,20].…”

Section: Introductionmentioning

confidence: 95%

Predictive risk factors for coronary artery abnormalities in Kawasaki disease

et al. 2006

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Clinical characteristics to predict the development of coronary artery abnormalities (CAA) in Kawasaki disease (KD) were assessed by reviewing medical records of patients diagnosed with KD at Korea University Medical Center from March 2001 to February 2005. Of the 285 patients diagnosed with KD, 19 developed CAA (6.7%). Compared with the CAA(-) group, the CAA(+) group had a longer duration of fever after intravenous gamma-globulin (IVGG) injection (2.4+/-2.9 vs. 1.5+/-1.2 days, p=0.008) and higher C-reactive protein (CRP)(12.3+/-7.8 vs. 8.7+/-7.1 mg/dL, p=0.038). In particular, the CAA(+) group tended to have more than 7 days of fever before IVGG and more than 3 days of fever after IVGG (26.3 vs. 5.3%, p<0.001; 26.3 vs. 6.4%, p=0.002). When the IVGG responsiveness was defined by the presence of defervescence within 3 days after IVGG, IVGG-non-responders showed a higher incidence of CAA (22.7 vs. 5.3%, p=0.002). Non-responders had a longer duration of fever after IVGG (5.5+/-1.9 vs. 1.2+/-0.6 days, p<0.001) and a significantly increased CRP, AST, ALT and total bilirubin. Multivariate regression analysis for CAA showed that the only factor significantly associated with the development of CAA was total fever that lasted for longer than 8 days (OR=4.052, 95% CI=1.151-14.263, p=0.0293). Conclusively, the most important predictor of CAA in KD is total duration of fever longer than 8 days. Early identification of IVGG non-responders and active therapeutic intervention for fever in KD cases might decrease the incidence of CAA.

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Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease

Abstract: The author's propose that a serum sodium concentration of <135 mEq/L at the patient's first visit to hospital may be a predictor of giant coronary aneurysms due to Kawasaki disease.

Cited by 69 publications

References 8 publications

Immunoglobulin preparations affect hyponatremia in Kawasaki disease

Immunoglobulin preparations affect hyponatremia in Kawasaki disease

Kawasaki disease and hyponatremia

Predictive risk factors for coronary artery abnormalities in Kawasaki disease

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