Preventing Coronary Artery Abnormalities
- 1 December 2012
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 31 (12), 1217-1220
- https://doi.org/10.1097/inf.0b013e318266bcf9
Abstract
Objectives: The aim of this study was to explore the timing of coronary artery (CA) abnormalities in light of the expanding clinical spectrum of Kawasaki disease (KD). Methods: We reviewed all cases of KD admitted to Children’s Hospital Colorado from January 2007 through February 2011 who had CA abnormalities. A retrospective chart review was conducted to collect demographic, clinical, laboratory and echocardiogram (ECHO) data. CA abnormalities were defined as Z score ≥2.5 or presence of ectasia or aneurysms. Results: A total of 210 patients with KD were identified. Fifty-seven (27.1%) of the 210 children with KD had CA abnormalities. Forty-six of the 57 (81%) children with CA abnormalities had CA abnormalities noted on their initial ECHO. Of the 46 children who had CA abnormalities detected on their initial ECHO, 37 (80%) had their ECHO on or before illness day 10. The median day of illness when abnormalities were detected on initial ECHO was day 7 (interquartile range: 5–8; range: 2–24 days). Only 25 of the 46 children (54%) were classified as complete KD, but 40 (87%) had the triad of conjunctivitis, rash and mucous membrane involvement. Thirteen (28%) had intravenous immunoglobulin–resistant disease. Conclusion: The majority of CA abnormalities in children with KD were identified in the initial ECHO, during the first week of illness. Earlier diagnosis and treatment is needed to impact the incidence of CA abnormalities in children with KD. Increased clinical suspicion and earlier use of ECHO in the initial workup of children with suspected KD may lead to more rapid diagnosis and treatment.Keywords
This publication has 19 references indexed in Scilit:
- Treatment of Kawasaki Disease: Analysis of 27 US Pediatric Hospitals From 2001 to 2006PEDIATRICS, 2009
- Risk factors for Kawasaki disease-associated coronary abnormalities differ depending on ageEuropean Journal of Pediatrics, 2009
- Kawasaki Disease in a Pediatric Intensive Care Unit: A Case-Control StudyPEDIATRICS, 2008
- Coronary Artery Involvement in Children With Kawasaki DiseaseCirculation, 2007
- Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart AssociationPEDIATRICS, 2004
- Diagnosis, Treatment, and Long-Term Management of Kawasaki DiseaseCirculation, 2004
- Kawasaki syndromeThe Lancet, 2004
- Results of the Nationwide Epidemiologic Survey of Kawasaki Disease in 1995 and 1996 in JapanPEDIATRICS, 1998
- A Single Intravenous Infusion of Gamma Globulin as Compared with Four Infusions in the Treatment of Acute Kawasaki SyndromeThe New England Journal of Medicine, 1991
- The Treatment of Kawasaki Syndrome with Intravenous Gamma GlobulinThe New England Journal of Medicine, 1986