Abstract 147: Coronary artery aneurysms on day 4 after onset of Kawasaki Disease: A Case report

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Anzai Tatsuya ◽  
Takaomi Minami ◽  
Sadahiro Furui ◽  
Kensuke Oka ◽  
Akiko Yokomizo ◽  
...  
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Laboratory Data ◽  
Density Lipoprotein ◽  
Artery Aneurysm ◽  
Main Trunk ◽  
Reactive Protein ◽  
Coronary Artery Dilatation ◽  
Old Japanese

Background: Coronary artery aneurysm (CAA) in patients with Kawasaki disease (KD) almost always occurs after day 8, and the most early detection report of CAA was in an autopsy case on day 6 after onset. The possibility of CAA formation prior to day 6 has not been documented. Case report: A 10-month-old Japanese boy presented with a 4-day fever, conjunctival injection, erythema of the lips, erythema of the palms and soles, erythematous rush, and induration at a Bacillus Calmette-Guerin inoculation site. On day 4, echocardiography revealed coronary artery dilatation (right coronary artery [RCA], 4.6 mm; left main trunk [LMT], 4.6 mm; left anterior descending [LAD] artery, 3.4 mm). Laboratory data were as follows: white blood cell count, 19,400/μL; C-reactive protein, 15.2 mg/dL; albumin, 3.2 g/dL; high-density lipoprotein cholesterol, 20 mg/dL, and erythrocyte sedimentation rate, 48 mm/h. He was diagnosed with KD and treated with oral aspirin 30 mg/kg/day and intravenous immunoglobulin (IVIG) 2 g/kg. His fever subsided the next day. On day 17, periungual peeling of the fingers and toes was noted. His fever recurred and he treated with additional IVIG 1 g/kg, after which his fever subsided again. On day 20, the aneurysms had not increased in size (RCA, 3.3 mm; LMT, 3.6 mm; LAD, 2.4 mm). On day 44, although echocardiography showed a mild coronary artery dilatation, a coronary angiogram showed no apparent abnormality. He had no obvious fever or symptoms of KD prior to this course of KD. This case may help clarify the pathophysiology of CAA in patients with KD.

scholarly journals Concomitant Coronary Artery Aneurysm and Myocarditis as a Rare Manifestation of Kawasaki Disease: A Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Aliasghar Halimiasl ◽  
Amir Hossein Hosseini ◽  
Reza Shiari ◽  
Parviz Ghadamli ◽  
Saeed Mojtahedzadeh
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Rare Manifestation

scholarly journals The Occurrence of Coronary Artery Lesions in Kawasaki Disease Based on C-reactive Protein Levels: A Retrospective Cohort Study

2020 ◽  
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 ◽  
Reactive Protein ◽  
Significant Difference ◽  
Z Scores

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.

Abstract 201: Risk Factors Of Persistent Coronary Artery Dilatation In Taiwanese Children With Kawasaki Disease.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Ming-Yu Liu ◽  
Hsin-Min Liu ◽  
Ming-Tai Lin ◽  
Chun-An Chen ◽  
Shuenn-Nan Chiu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Laboratory Data ◽  
Disease Onset ◽  
Z Score ◽  
Fever Onset ◽  
Coronary Artery Dilatation ◽  
Coronary Abnormalities ◽  
Over Time

Background: Kawasaki disease (KD) is an acute, systemic vasculitis disease of childhood, which may lead to cardiovascular complications, particularly coronary artery (CA) dilatation or aneurysm formation, and could result in morbidity and mortality. The Z score of coronary artery decreased from initial value within first few 2-3 months after fever onset. We follow the echocardiographic measurements of KD patients over time, and attempt to find the associated factors of persistent dilated coronary artery. Methods: Initial presentations, clinical laboratory data, echocardiography measurements and treatment were obtained from the patients with acute Kawasaki disease over 4 years period in a single medical center hospital. The patients were divided into 3 groups according to the initial maximum Z score of any coronary artery which were normalized for body surface area. We followed the echocardiography regularly at initial acute phase, 2-4 week, 5-12week, and > 3 months after fever onset. The maximal Z score of any coronary artery branches > +2 at any time were defined as having abnormalities. Results: We included total 169 patients with acute KD during 2008-2012. A maximal Z score for any of the coronary artery branches greater than +2 at acute phase was noted in 31.4% (53 of 169) of patients. During the following-up period, all except one patients (1 of 138) of the patients with initial maximal Z score <+2.5, the coronary artery have no abnormality at the end of following up. In contrast, the patients with initial maximal Z score≧+2.5 were more likely to have persistent coronary abnormalities over time (5 of 31, P<0.001). We also found hypoalbuminemia (P=0.006) and unresponsiveness to initial intravenous immunoglobulin treatment (P<0.001) associated with deteriorated or persistent CA abnormality within one month of disease onset. Conclusion: Coronary artery dilatation with Z score≧+2.5 at acute phase of Kawasaki disease, hypoalbuminemia and IVIG unresponsiveness are significantly associated with persistent CA abnormality at one month after KD onset. That indicated how to avoid IVIG unresponsiveness at the initial treatment of KD is a critical issue.

Concomitant Coronary Artery Aneurysm and Myocarditis as a Rare Manifestation of Kawasaki Disease: A Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Aliasghar Halimiasl ◽  
Amir Hossein Hosseini ◽  
Reza Shiari ◽  
Parviz Ghadamli ◽  
Saeed Mojtahedzadeh
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Rare Manifestation

scholarly journals Predictors for coronary artery dilatation in Kawasaki disease

2018 ◽  
Vol 58 (5) ◽  
pp. 257-62
Author(s):  
Najib Advani ◽  
Anisa Rahmadhany ◽  
Sarah Rafika
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Predictive Factors ◽  
Laboratory Data ◽  
Febrile Illness ◽  
Heart Association ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Coronary Artery Dilatation

Background Kawasaki disease (KD) is an acute, self-limited, febrile illness of unknown cause that predominantly affects children below 5 years of age. It has a high incidence of coronary complications such as aneurysms. The current treatment of choice is intravenous immunoglobulin, which is costly, with aspirin. Identifying the predictive factors for coronary artery dilatation or aneurysm is important in order to establish the indications for giving immunoglobulin, especially when resources are limited. Objective To identify the predictors for the development of coronary artery dilatation in patients with Kawasaki disease Methods This cross-sectional study was done between January 2003 and July 2013. Inclusion criteria were patients who fulfilled the American Heart Association criteria for acute Kawasaki disease, and had complete clinical, echocardiogram, and laboratory data [hemoglobin, leukocyte, platelet, albumin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)]. All of them received immunoglobulin and aspirin. Results Of 667 KD patients, 275 met the inclusion criteria. There were 185 (67%) males. Subjects’ ages varied between 1 to 157 months. The frequency of coronary artery dilatation at the acute phase was 33.3%. Multivariate analysis showed that >7-day duration of fever and hypoalbuminemia were significant predictive factors for coronary artery dilatation. Conclusion Predictive factors for coronary artery dilatation are duration of fever over 7 days and hypoalbuminemia, while age, gender, hemoglobin level, leukocyte count, and platelet count are not. Frequency of coronary artery dilatation at the acute phase is 33.3%.

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

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.

Abstract 44: Uveitis As An Important Ocular Sign To Help Early Diagnosis In Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Young Mi Hong ◽  
Han Seul Choi ◽  
Hae Soon Kim ◽  
Sejung Sohn
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Laboratory Data ◽  
Artery Aneurysm ◽  
Control Group ◽  
Echocardiographic Measurement ◽  
Arterial Complication ◽  
Increased Risk ◽  
Significant Difference ◽  
Treatment Responses

Purpose: Atypical or incomplete Kawasaki disease (KD) frequently leads to delay in diagnosis and treatment. Delayed diagnosis is associated with increased risk of coronary artery aneurysm. Anterior uveitis peaks about a week after the onset of fever. The purpose of this study was to assess the differences in laboratorial findings including echocardiographic measurements, clinical characteristics such as duration of fever and treatment responses between KD patients with and without uveitis. Materials and Methods: 106 KD patients were studied from January 2008 to June 2013. Study group (n=28, KD with uveitis) was compared with control group (n=78, KD without uveitis). Laboratory data were obtained from each patients including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total protein, albumin, C-reactive protein (CRP), brain natriuretic peptide (BNP). Echocardiographic measurement and intravenous immunoglobulin responses were compared between two groups. Result: The incidence of uveitis was 26.4%. Neutrophil counts were higher in the uveitis group compared with the control group (64.3±15.8(х10 3 /mm 3 ) vs. 54.4±19.3 (х10 3 /mm 3 )). The age of patients was higher in the uveitis group compared with the control group (40.5±21.4 months vs. 33.4±29.3 months). ESR (43.3±27.2 mm/hr vs. 30.8±24.6 mm/hr) and CRP (8.1±6.1 mg/dL vs. 7.9±10.7mg/dL) were slightly increased in the uveitis group compared with the control group, but there was no significant difference between the two groups. Coronary artery diameter was slightly increased in the uveitis group but there was no significant difference between the two groups. There were no significant differences in duration of fever, BNP, coronary arterial complication and treatment responses between the two groups. Conclusion: Uveitis is the one of the important ocular signs to diagnose incomplete KD. It is significantly associated with the patient’s age and neutrophil count but not with the other laboratory measurements, coronary arterial complication or treatment responses.

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