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The Factors on the Development of Coronary Arterial Involvement in Kawasaki Disease

Journal of the Korean Pediatric Society 1992;35(10):1328-1335.
Published online October 15, 1992.
The Factors on the Development of Coronary Arterial Involvement in Kawasaki Disease
Sang Yen Kim, Jong Hyun Kim, Jong In Byun, Won Bae Lee, Byung Churl Lee, Kyung Tai Whang, Kyong Su Lee, Sung Hoon Cho
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
Kawasaki병에서 관상동맥 병변에 영향을 주는 인자들
김상연, 김종현, 변종인, 이원배, 이병철, 황경태, 이경수, 조성훈
가톨릭대학교 의과대학 소아과학교실
Abstract
In Kawasaki disease, coronary arterial involvement is an important prognostic factor. Many studies have reported about risk factors of coronary artery disease in Kawasaki disease. This study was designed to evaluate factors influencing coronary arterial involvement and to evaluate the effect of intravenous gammaglobulin (IVG) when admitted on the widely used criteria in Korea. Fiftyfour patients meeting the CDC criteria for Kawasaki disease were studied from January 1984 to March 1991. To evaluate coronary arterial involvement, M-mode and 2-D echocardiography was performed. Twenty out of 54 patients showed coronary arterial involvement. Age, sex, fever duration, many laboratory findings, Nakano's score were evaluated and effect of IVG administration was evaluated, too. The results were as follows: 1) Age at onset did not influence to the development of coronary arterial disease. 2) Male children were more frequently affected by Kawasaki disease, but sex did not influence to the coronary arterial disease. 3) Total fever duration was 8.1¡¾3.0 days in uninvolved group, 10.0¡¾4.6 days in involved group, and there was significant difference (p<0.05). 4) Hematocrit on admission was 34.4¡¾2.8% in uninvolved group and 34.3¡¾3.6% in involved group. The lowest hematocrit value during admission was 32.1¡¾2.4% in uninvolved group and 30.8¡¾3.6% in involved group. The lowest hematocrit value had significance (p<0.05). 5) There was no relationshiip between laboratory findings including WBC, neutrophile, lymphocyte, platelet count, ESR, CRP, and coronary arterial involvement. 6) Nakano's score was 1.7¡¾1.5 point in univolved group and 1.5¡¾1.8 point in involved group and there was not significant difference. 7) Twenty-one children were treated by aspirin only and 8 children were treated by aspirin and IVG in involved group. There was no significant difference of coronary involvement between two groups threated with ASA only, and ASA and IVG. There was no significant difference of fever duration between two groups. But we found rapid drop of fever after IVG administration (1.7¡¾0.6 days). These findings indicated that IVG treatment had been delayed on the basis of the criteria we had used. In conclusion prolonged fever duration and decreased hamatocrit value affected coronary arterial involvement in Kawasaki disease. And early administration of IVG could decrease the prevalence of coronary arterial involvement in Kawasaki disease. And early administration of IVG could decrease the prevalence of coronary arterial involvement.
Key Words: Kawasaki disease, Coronary arterial involvement, Intravenous gammaglobulin, Hematocrit, Fever duration


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