Coronary artery lesions of incomplete Kawasaki disease: a nationwide survey in Japan

Abstract BackgroundThis study aimed to assess the occurrence of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) according to serum C-reactive protein (CRP) levels. MethodsThis retrospective analysis was based on the nationwide survey of KD conducted in the Republic of Korea between 2015 and 2017. We enrolled 9131 patients and defined low (<3 mg/dL) and high (≥3 mg/dL) CRP groups. Demographic data, clinical characteristics, z-scores, and scores based on the Japanese criteria for CAL were compared between the two groups. Logistic regression analysis was used to identify CAL risk factors.ResultsThe low CRP group accounted for 23% of patients. A significant difference was observed for the mean age at diagnosis (high vs. low CRP, 34.4 ± 24.9 vs. 31.7 ± 24.8 months, p<0.001) and fever duration (high vs. low CRP, 6.6 ± 2.2 vs. 6.3 ± 2.5 days, p<0.001). A non-response to intravenous immunoglobulin treatment was found in 1377 patients (20.1%) and 225 patients (11.7%) in the high and low CRP groups, respectively (p<0.001). CAL were found in 12.9% and 18.3% of the high and low CRP patients, respectively (p<0.001), based on z-scores; and in 9.9% and 12.5%, respectively (p = 0.001), based on the Japanese criteria in the acute phase. The giant coronary artery aneurysm occurrence ratio was similar between groups (p=1.0).ConclusionsCAL occurred in patients with both high and low CRP. Therefore, patients with KD should be carefully monitored regardless of their CRP levels.

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Affects of "Age at Diagnosis" on Coronary Artery Lesions in Patients With Incomplete Kawasaki Disease

Korean Circulation Journal ◽

10.4070/kcj.2010.40.6.283 ◽

2010 ◽

Vol 40 (6) ◽

pp. 283 ◽

Cited By ~ 3

Author(s):

Min A Cho ◽

Yeon Joo Choi ◽

Jo Won Jung

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Age At Diagnosis ◽

Coronary Artery Lesions ◽

Incomplete Kawasaki Disease

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Explainable Deep Learning Algorithm for Distinguishing Incomplete Kawasaki Disease by Coronary Artery Lesions on Echocardiographic Imaging (Preprint)

10.2196/preprints.27053 ◽

2021 ◽

Author(s):

Haeyun Lee ◽

Yongsoon Eun ◽

Jae Youn Hwang ◽

Lucy Youngmin Eun

Keyword(s):

Deep Learning ◽

Coronary Artery ◽

Kawasaki Disease ◽

Learning Algorithm ◽

Clinical Manifestations ◽

Learning Networks ◽

Coronary Artery Lesions ◽

Incomplete Kawasaki Disease ◽

Deep Learning Algorithm

BACKGROUND Incomplete Kawasaki disease (KD) has often been misdiagnosed due to a lack of the clinical manifestations of classic KD. However, it is associated with a markedly higher prevalence of coronary artery lesions. Identifying coronary artery lesions by echocardiography is important for the timely diagnosis of and favorable outcomes in KD. Moreover, similar to KD, coronavirus disease 2019, currently causing a worldwide pandemic, also manifests with fever; therefore, it is crucial at this moment that KD should be distinguished clearly among the febrile diseases in children. OBJECTIVE In this study, we aimed to validate a deep learning algorithm for classification of KD and other acute febrile diseases. METHODS We obtained coronary artery images by echocardiography of children (n = 88 for KD; n = 65 for pneumonia). We trained six deep learning networks (VGG19, Xception, ResNet50, ResNext50, SE-ResNet50, and SE-ResNext50) using the collected data. RESULTS SE-ResNext50 showed the best performance in terms of accuracy, specificity, and precision in the classification. SE-ResNext50 offered a sensitivity of 82.64% and a specificity of 58.12%. CONCLUSIONS The results of our study suggested that deep learning algorithms have similar performance to an experienced cardiologist in detecting coronary artery lesions to facilitate the diagnosis of KD. CLINICALTRIAL none

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Clinical aspects of splenomegaly as a possible predictive factor of coronary artery changes in Kawasaki disease

Cardiology in the Young ◽

10.1017/s1047951118002238 ◽

2018 ◽

Vol 29 (3) ◽

pp. 297-302 ◽

Cited By ~ 1

Author(s):

Dong Wan Kang ◽

Sung Hoon Kim

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Cervical Lymphadenopathy ◽

Clinical Aspects ◽

Acute Acalculous Cholecystitis ◽

Coronary Artery Lesions ◽

Incomplete Kawasaki Disease ◽

Abdominal Ultrasonography ◽

Laboratory Findings ◽

Gallbladder Hydrops

AbstractBackgroundAlthough many clinical features that are not typically included in the diagnostic criteria for Kawasaki disease, such as gall bladder hydrops, are known to occur with Kawasaki disease, splenomegaly is not concerned. We investigated the relationship of splenomegaly with the development of coronary artery lesions in Kawasaki disease.Methods and resultsThis retrospective descriptive study was conducted through a review of medical records of children with Kawasaki disease from March 2011 to February 2017. We analysed information regarding clinical presentation, treatment, hospital stay, and outcome. A total of 396 patients during this 6-year period met the enrolment criteria. Of these, 77 (23.4%) underwent abdominal ultrasonography during the treatment period. The patients included 46 males and 31 females with an average age of 35.8 ± 26.1 months. Gallbladder hydrops were detected in 32 patients, and acute acalculous cholecystitis was not found. Splenomegaly was detected in 21 patients. Kawasaki disease patients with gallbladder hydrops had no statistical difference in clinical or laboratory findings or in development of coronary artery lesions compared to patients without gallbladder hydrops. However, patients with splenomegaly belonged more to incomplete Kawasaki disease, had longer fever duration, had more frequent cervical lymphadenopathy and polymorphous rash, had higher neutrophil percentage, N-terminal fragment of pro-brain natriuretic peptide, and alanine aminotransferase levels, and a higher incidence of coronary artery lesions than patients without splenomegaly.ConclusionSplenomegaly belongs to incomplete Kawasaki disease patients mainly with a higher incidence of coronary artery lesions than that of patients without it.

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The occurrence of coronary artery lesions in Kawasaki disease based on C-reactive protein levels: a retrospective cohort study

Pediatric Rheumatology ◽

10.1186/s12969-021-00566-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Hyo Soon An ◽

Gi Beom Kim ◽

Mi Kyoung Song ◽

Sang Yun Lee ◽

Hye Won Kwon ◽

...

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

Demographic Data ◽

Artery Aneurysm ◽

Nationwide Survey ◽

Coronary Artery Lesions ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Z Scores

Abstract Background This study aimed to assess the occurrence of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) according to serum C-reactive protein (CRP) levels. Methods This retrospective analysis was based on the nationwide survey of KD conducted in the Republic of Korea between 2015 and 2017. We enrolled 9131 patients and defined low (< 3 mg/dL) and high (≥3 mg/dL) CRP groups. Demographic data, clinical characteristics, z-scores, and scores based on the Japanese criteria for CAL were compared between the two groups. Logistic regression analysis was used to identify CAL risk factors. Results The low CRP group accounted for 23% of patients. The mean age at diagnosis was higher in high CRP group compared to the low CRP group (34.4 ± 24.9 vs 31.7 ± 24.8 months, p < 0.001). Fever duration before treatment was not significantly different between the two groups (5.1 ± 1.7 days vs. 5.2 ± 2.1 days; p = 0.206). A non-response to intravenous immunoglobulin treatment was found in 1377 patients (20.1%) and 225 patients (11.7%) in the high and low CRP groups, respectively (p < 0.001). CAL were found in 12.9 and 18.3% of the high and low CRP patients, respectively (p < 0.001), based on z-scores; and in 9.9 and 12.5%, respectively (p = 0.001), based on the Japanese criteria in the acute phase. The giant coronary artery aneurysm occurrence ratio was similar between groups (p = 1.0). Conclusions CAL occurred in patients with both high and low CRP. Therefore, patients with KD should be carefully monitored regardless of their CRP levels.

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