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%.

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.

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.

The impact of the American Heart Association guidelines on patients treated for incomplete Kawasaki disease

2021 ◽  
pp. 1-5
Author(s):  
Megan M. Blaney ◽  
Richard V. Williams ◽  
Igor A. Areinamo ◽  
Michael Sauer ◽  
Lloyd Y. Tani ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
American Heart Association ◽  
American Heart ◽  
Laboratory Data ◽  
Heart Association ◽  
Incomplete Kawasaki Disease ◽  
Exact Test ◽  
Coronary Artery Abnormalities ◽  
The Impact

Abstract Objectives: To compare patients treated for incomplete Kawasaki disease whose practitioners followed versus did not follow American Heart Association criteria and to evaluate the association of cardiology consultation with adherence to these guidelines. Study design: Single centre retrospective cohort study of patients <18 years old who received ≥1 dose of intravenous immunoglobulin for Kawasaki disease between 01/2006 and 01/2018. We collected demographics, clinical and laboratory data, coronary artery abnormalities, and cardiology consultation status. Patients treated for incomplete Kawasaki disease were divided into two groups based on adherence versus nonadherence to American Heart Association guidelines and compared by Wilcoxon rank sum test and chi-squared or Fisher’s exact test. Results: Of the 357 patients treated for Kawasaki disease, 109 (31%) were classified as incomplete Kawasaki disease. The American Heart Association algorithm for identifying patients with incomplete Kawasaki disease was followed in 81/109 (74%). Coronary artery abnormalities were present in 46/109 (42%) of the patients who were treated for incomplete Kawasaki disease. Cardiology consultation was more frequent in those fulfilling American Heart Association criteria for the diagnosis of incomplete Kawasaki disease versus those who did not fulfill criteria (76% versus 48%, p = 0.005). Conclusions: Over 25% of patients treated for incomplete Kawasaki disease did not meet American Heart Association guidelines. Guidelines were more frequently followed when the paediatric cardiology team was consulted. Consulting physicians with experience and expertise in the evaluation and management of incomplete KD should be strongly considered in the care of these patients.

scholarly journals Desquamation in Kawasaki Disease

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 317
Author(s):  
Ling-Sai Chang ◽  
Ken-Pen Weng ◽  
Jia-Huei Yan ◽  
Wan-Shan Lo ◽  
Mindy Ming-Huey Guo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Laboratory Data ◽  
Ivig Treatment ◽  
Low Grade ◽  
High Grade ◽  
Laboratory Findings ◽  
Coronary Artery Abnormalities ◽  
Cell Counts ◽  
Hands And Feet

(1) Background: Desquamation is a common characteristic of Kawasaki disease (KD). In this study, we analyzed patients’ varying desquamation levels in their hands or feet, in correlation with clinical presentation, to assess the relationship. (2) Methods: We retrospectively reviewed children with KD. We analyzed their age, laboratory data before intravenous immunoglobulin (IVIG) treatment and coronary artery abnormalities (CAA) based on the desquamation level of their hands and feet. We classified the desquamation level from 0 to 3 and defined high-grade desquamation as grade 2 and 3. (3) Results: We enrolled a total 112 patients in the study. We found the hands’ high-grade desquamation was positively associated with age and segmented neutrophil percentage (p = 0.047 and 0.029, respectively) but negatively associated with lymphocyte and monocyte percentage (p = 0.03 and 0.006, respectively). Meanwhile, the feet’s high-grade desquamation was positively associated with total white blood cell counts (p = 0.033). Furthermore, we found that high-grade hand desquamation had less probability of CAA formation compared with that of a low grade (7.1% vs. 40.8%, p = 0.016). (4) Conclusions: This report is the first to demonstrate that the desquamation level of hands or feet in KD is associated with different coronary artery abnormalities and laboratory findings.

scholarly journals 0328: Evaluation of coronary artery wall echogenicity in Kawasaki disease acute phase

2015 ◽  
Vol 7 (1) ◽  
pp. 102
Author(s):  
Fanny Riou ◽  
Aurélie Chalard ◽  
Aurélie Chausset ◽  
Jean René Lusson ◽  
Etienne Merlin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Artery Wall ◽  
Coronary Artery Wall

scholarly journals Evaluation of coronary artery wall echogenicity in Kawasaki disease acute phase

2014 ◽  
Vol 107 (8-9) ◽  
pp. 485
Author(s):  
F. Riou ◽  
A. Chalard ◽  
A. Chausset ◽  
J.R. Lusson ◽  
E. Merlin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Artery Wall ◽  
Coronary Artery Wall

Atypical coronary artery aneurysms due to Kawasaki disease in Noonan syndrome with a novel PTPN11 mutation

2018 ◽  
Vol 29 (2) ◽  
pp. 228-230
Author(s):  
Shiori Takai ◽  
Kei Takasawa ◽  
Shozaburo Doi
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Therapeutic Intervention ◽  
Noonan Syndrome ◽  
Coronary Artery Aneurysms ◽  
Ptpn11 Mutation

AbstractWe report a 3-year-old boy with giant and atypical coronary artery aneurysms in the acute phase of Kawasaki disease, despite appropriate therapeutic intervention, in Noonan syndrome with a novel heterozygous PTPN11 mutation, c. 907 G>A (p.Asp303Asn). We hypothesised that this PTPN11 mutation might affect both hyperinflammation caused by Kawasaki disease and vascular fragility in the coronary artery, resulting in coronary artery aneurysms.

scholarly journals ANALYZE THE TREATMENT REGIMENS AND THROMBOSIS PROPHYLAXIS USED IN CORONARY ARTERY INTERVENTION AT INTERVENTIONAL CARDIOLOGY UNIT IN CAN THO CENTRAL GENERAL HOSPITAL

2019 ◽  
pp. 1-4
Author(s):  
VU TRI-THANH ◽  
NGUYEN-HUYNH DUNG-TAM
Keyword(s):  
Clinical Trials ◽  
Coronary Artery ◽  
General Hospital ◽  
Treatment Time ◽  
Heart Association ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Thrombosis Prophylaxis ◽  
Cross Sectional ◽  
Treatment Regimens

Objective: The study was conducted to analyze the rationality of treatment regimens and thrombosis prophylaxis used in coronary artery intervention to compare to guidelines for treatment according to VNHA and recommendation of ACC/AHA at Interventional cardiology in Can Tho Central General Hospital. Methods: The cross-sectional study was based on the data collected from entire medical records of patients at Interventional cardiology in Can Tho Central General Hospital from August 2017 to February 2018. The rationality of the antithrombotic regimen used at the Hospital is assessed through criteria such as medical combination, dosage, time to take medicine, clinical trials during the treatment. Results: The study found that 95.6% and 90.7% were suitable for medical combination before and after PCI; 100% fit for the use of medicine; and 100% was suitable for antithrombotic agents and clinical trials during treatment time; in terms of dosage, the result showed that entrance and maintenance were 84.9% and 100% for aspirin respectively; 71.7% and 100% for clopidogrel; 100% and 94.7% for ticagrelor; 90.2-92.8% and 98.1% for enoxaparin; especially, heparin-100% anticoagulant was appropriate to recommend. Conclusion: The study showed that treatment regimens and thrombosis prophylaxis in percutaneous coronary intervention at Interventional cardiology in Can Tho Central General Hospital were quite suitable compared to the recommendations of the Heart Association. The results from the study are a scientific basis for the Hospital to maintain or consider adjustments to improve the quality of treatment, ensure the effectiveness and safety of patients.

Kawasaki Disease in a Patient With Williams Syndrome

2018 ◽  
Vol 11 (4) ◽  
pp. NP144-NP147
Author(s):  
Aleisha M. Nabower ◽  
Lois J. Starr ◽  
Jonathan Cramer
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Williams Syndrome ◽  
Coronary Arteries ◽  
Incomplete Kawasaki Disease ◽  
Cardiac Anomalies ◽  
Coronary Artery Dilatation ◽  
Coronary Aneurysms

Kawasaki disease can be difficult to diagnose in infants, putting them at higher risk for developing coronary artery dilatation. It can be even more difficult to diagnose in the setting of preexisting cardiac anomalies such as those found in Williams syndrome. We present a case of a three-month-old male with Williams syndrome with rapidly developing giant coronary aneurysms due to Kawasaki disease. This case demonstrates the importance of repeat echocardiography in diagnosing incomplete Kawasaki disease in infants. We speculate that elastin changes, as present in Williams syndrome, may put affected children at higher risk for development of giant coronary arteries should they acquire Kawasaki disease.

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