All issues > Volume 52(10); 2009

Original Article

Korean J Pediatr. 2009;52(10):1161-1166. Published online October 15, 2009.

Predictive indicators of coronary artery complications in Kawasaki disease

Min Jee MJ Park¹, In-sang Is Jeon¹, Hann H Tchah¹, Kang Ho KH Cho¹, Mi-Jin MJ Jung¹, Deok Young DY Choi¹

¹Department of Pediatrics, Graduate School of Medicine, University of Medicine and Science, Incheon, Korea

Correspondence Deok Young DY 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.

Keywords :Kawasaki disease, Coronary artery, Complication, Predictive indicators