Korean Journal of Pediatrics 2009;52(10):1161-1166.
Published online October 15, 2009.
Predictive indicators of coronary artery complications in Kawasaki disease
Min Jee Park, In-sang Jeon, Hann Tchah, Kang Ho Cho, Mi-Jin Jung, Deok Young Choi
Department of Pediatrics, Graduate School of Medicine, University of Medicine and Science, Incheon, Korea
가와사키 병 환아에서 관상동맥 합병증의 예측인자
박민지, 전인상, 차한, 조강호, 정미진, 최덕영
가천의과대학교 의학전문대학원
Correspondence: 
Deok Young Choi, Email: pskcdy@gilhospital.com
Abstract
Purpose
: Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data.
Methods
: Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data.
Results
: Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2–3-fold, respectively.
Conclusion
: The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.
Key Words: Kawasaki disease, Coronary artery, Complication, Predictive indicators


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