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Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience

  • Short Communication - Observational Research
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Abstract

Kawasaki disease (KD) is an acute systemic vasculitis of childhood. Due to development of coronary artery aneurysms (CAA) it is considered the most common cause of acquired heart disease in children. The clinical and laboratory features of patients with complete and incomplete KD were compared in order to identify the possible predictors of CAA development. A cross-sectional study of children with KD treated at the University Hospital for Infectious Diseases, Zagreb, between January 2003 and December 2012 was conducted. A total of 111 KD patients were included; 70.3 % patients had complete KD. Patients with complete KD had more frequently rash, changes on extremities and mucous membranes, as well as higher serum bilirubin, aminotransferases, gamma-glutamyl transferase and lactate dehydrogenase levels. Patients with incomplete KD had longer duration of fever before the diagnosis (8 vs. 7 days) and delayed IVIG treatment (day 8 vs. 7). CAA was detected in seven children (6.3 %). Disease duration before hospitalization >6 days (OR 7.16, 95 % CI 1.51–100.35), age <6 months (OR 25.86, 95 % CI 1.68–398.35) and platelet count >771 after the 7th day of disease (OR 13.33, 95 % CI 2.19–80.87) were independently associated with CAA development. The diagnosis and treatment in incomplete KD can be delayed due to the absence of major criteria. Age, duration of symptoms prior hospitalization and platelet count were identified as independent predictors of CAA development.

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Acknowledgments

The authors thank Mrs. Arijana Pavelić for her help in the preparation of the manuscript.

Conflict of interest

All the authors hereby declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Clinical Department for Pediatric Infectious Diseases, University Hospital for Infectious Zagreb, Mirogojska 8, 10 000, Zagreb, Croatia

    Lorna Stemberger Maric, Ivica Knezovic, Branko Mise, Srdan Roglic, Leo Markovinovic & Goran Tesovic

  2. Department for Viral Hepatitis, Zagreb, University Hospital for Infectious Diseases, Zagreb, Croatia

    Neven Papic

  3. School of Medicine, Unversity of Zagreb, Zagreb, Croatia

    Branko Mise & Goran Tesovic

Authors
  1. Lorna Stemberger Maric
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  2. Ivica Knezovic
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  3. Neven Papic
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  4. Branko Mise
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  5. Srdan Roglic
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  6. Leo Markovinovic
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  7. Goran Tesovic
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Correspondence to Lorna Stemberger Maric.

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Maric, L.S., Knezovic, I., Papic, N. et al. Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience. Rheumatol Int 35, 1053–1058 (2015). https://doi.org/10.1007/s00296-014-3186-9

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  • DOI: https://doi.org/10.1007/s00296-014-3186-9

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