Correlation Analysis of Anti-Cardiolipin Antibody/D Dimer/C-Reactive Protein and Coronary Artery Lesions/Multiple-Organ Damage in Children With Kawasaki Disease

Aim: Kawasaki disease (KD) is a systemic vasculitis with unknown etiology. In addition to cardiovascular system involvement, it can also have other multiple organs involved. This study is aimed at investigating the correlation between anti-cardiolipin antibody (ACA)/D dimer/C reactive protein (CRP) and coronary artery lesions (CAL)/multiple-organ lesions in children with KD.Methods: Retrospective analysis was performed in 284 KD/IKD patients from May 2015 to April 2016. Among them, 175 were males (61.6%), with average age of 2 years and 5 months old. Patients were divided into ACA+ group and ACA- group, elevated D dimer group (DDE) and normal D dimer group (DDN), and coronary artery injury (CAL) group and non-coronary artery injury (NCAL) group.Results: ACA was most likely tested positive in younger KD children (p < 0.05). ACA+ and hypoproteinemia were correlated with CAL, thrombocytosis, and granulocytopenia (p < 0.05–0.01). Levels of cTnI and CK in the CAL group were significantly higher than those in the NCAL group (p < 0.05). CAL was more frequently detected in younger patients and patients with prolonged fever, later IVIG treatment, and elevated CRP over 100 mg/l, but there was no statistically significant difference (all p > 0.05). In the KD with DDE group, the incidence of granulopenia, thrombocytosis, myocardial damage, cholestasis, hypoproteinemia, and aseptic urethritis was significantly higher than that in the KD with DDN group (p < 0.05–0.01). However, elevated D dimer was not associated with CAL. CRP elevation was highly correlated with D dimer, but not with CAL.Conclusion: Higher incidence of CAL and myocardial damage occurred in KD patients with positive ACA and hypoproteinemia. In the current study, ACA was only tested for positive and negative, which is a limitation to this study. To further elucidate the association, ACA titers would establish its significance in drawing a conclusion for the significance of ACA in CAL and myocardial damages. In addition, higher incidence of CAL occurred in younger patients. The higher D dimer was associated with increased multiple-organ damage (MOD). CRP was closely correlated with D dimer, but not correlated with ACA and CAL.

Download Full-text

Case Report of Multisystem Inflammatory Syndrome in a Child Related to COVID-19

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v20i2.56482 ◽

2021 ◽

Vol 20 (2) ◽

pp. 89-92

Author(s):

Faisal Ahmed ◽

Hasan Zahid ◽

Moinul Hasan ◽

Anwar Hossain ◽

Md Arman Zaid ◽

...

Keyword(s):

Case Report ◽

Cardiac Dysfunction ◽

Digestive System ◽

Multiple Organ ◽

C Reactive Protein ◽

Paediatric Ward ◽

Reactive Protein ◽

Ankle Joints ◽

Inflammatory Syndrome ◽

D Dimer

Background : Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition that appears to be linked to Coronavirus Disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. Aim of this study to evaluate the children who go on to develop MIS-C, some organs and tissues-such as the heart, lungs, blood vessels, kidneys, digestive system, brain, joints, skin or eyes -become severely inflamed. Case Report : 11 years old girl admitted in Paediatric Ward of in Imperial Hospital Chattogram on 12 July 2020 with the complains of fever, loose motion, rash in hands, body and legs, swelling of the wrist and ankle joints which were associated with anorexia, nausea , vomiting and bodyache. For this reason the child was evaluated. Conclusion : Clinical features in children have varied but predominantly include cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-Reactive Protein (CRP) Ferritin, D-dimer and Interleukin-6. MIS-C can lead to shock and multiple organ failure requiring intensive care. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 89-92

Download Full-text

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

10.21203/rs.3.rs-113714/v1 ◽

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.

Download Full-text

Vagal function indexed by respiratory sinus arrhythmia and high sensitivity C-reactive protein: Influence of coronary artery lesions and cardiovascular risk factor

Autonomic Neuroscience ◽

10.1016/j.autneu.2013.08.035 ◽

2013 ◽

Vol 177 (2) ◽

pp. 309

Author(s):

Nayara Yamada Tamburus ◽

Vandeni Clarice Kunz ◽

Ester da Silva

Keyword(s):

Risk Factor ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Cardiovascular Risk Factor ◽

High Sensitivity ◽

Coronary Artery Lesions ◽

C Reactive Protein ◽

Sinus Arrhythmia ◽

Reactive Protein ◽

Vagal Function

Download Full-text

Significant Relationship Between Serum High-sensitivity C-Reactive Protein, High-density Lipoprotein Cholesterol Levels and Children With Kawasaki Disease and Coronary Artery Lesions

Journal of the Formosan Medical Association ◽

10.1016/s0929-6646(09)60395-8 ◽

2009 ◽

Vol 108 (9) ◽

pp. 719-724 ◽

Cited By ~ 13

Author(s):

Chun-Yen Ou ◽

Yu-Fang Tseng ◽

Cheng-Liang Lee ◽

Yee-Hsuan Chiou ◽

Kai-Sheng Hsieh

Keyword(s):

Coronary Artery ◽

Kawasaki Disease ◽

High Density Lipoprotein ◽

High Density Lipoprotein Cholesterol ◽

Density Lipoprotein ◽

High Sensitivity ◽

Coronary Artery Lesions ◽

C Reactive Protein ◽

Reactive Protein ◽

Cholesterol Levels

Download Full-text

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.

Download Full-text