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Clinical characteristics of Kawasaki disease in Polish children: A retrospective study

Anna Smorczewska-Kiljan1, Magdalena Marszał1, Joanna Friedman-Gruszczyńska2, Anna Wieteska-Klimczak1, Janusz Książyk1, Maciej Jaworski3, Piotr Buda1
DOI: 10.33963/KP.a2022.0090
·
Pubmed: 35380006
Affiliations
  1. Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warszawa, Poland
  2. Department for Pediatric and Congenital Heart Surgery, The Children's Memorial Health Institute, Warszawa, Poland
  3. Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warszawa, Poland

open access

Online first
Original article
Published online: 2022-04-04

Abstract

Background: Kawasaki disease (KD), an acute, generalized vasculitis, is associated with an increased risk of coronary heart disease and is the most common cause of acquired heart disease in childhood. The incidence of KD is increasing worldwide.

Aims: Our study aims to analyze KD’s clinical course in children and to evaluate risk factors for persistent changes in coronary vessels after 6–8 weeks of treatment.

Methods: The retrospective analysis included patients with KD hospitalized in a single tertiary care hospital. The diagnosis, as well as treatment, were based on the current worldwide treatment standards. The clinical course, selected laboratory parameters, the treatment effect, and following cardiac complications were analyzed in different age groups.

Results: In the years 2006–2019, 140 patients aged two months to 16 years, 52 girls, and 88 boys were diagnosed with KD. Coronary artery aneurysms (CAA) at week 6-8 of disease were found in 16% of patients. Boys and infants were more likely to develop aneurysms at the week 6–8 of disease (P = 0.045, P = 0.03, respectively). Their frequency was related to the atypical course (P = 0.02), late diagnosis (P = 0.04), presence of changes in the coronary arteries at the time of diagnosis (P <0.001), immunoglobulin resistance (P = 0.002), a lower hemoglobin value (P <0.001), and a higher platelet value (P = 0.02).

There were 28% of patients with resistance to first-line time treatment. In this group, we found CAA in 31% of children.

Conclusions: We found late diagnosis, low hemoglobin level, high platelet count, CAA presence at diagnosis, atypical course of KD, and resistance to intravenous immunoglobulins are predictors of CAA after 6–8 weeks in KD patients.

Abstract

Background: Kawasaki disease (KD), an acute, generalized vasculitis, is associated with an increased risk of coronary heart disease and is the most common cause of acquired heart disease in childhood. The incidence of KD is increasing worldwide.

Aims: Our study aims to analyze KD’s clinical course in children and to evaluate risk factors for persistent changes in coronary vessels after 6–8 weeks of treatment.

Methods: The retrospective analysis included patients with KD hospitalized in a single tertiary care hospital. The diagnosis, as well as treatment, were based on the current worldwide treatment standards. The clinical course, selected laboratory parameters, the treatment effect, and following cardiac complications were analyzed in different age groups.

Results: In the years 2006–2019, 140 patients aged two months to 16 years, 52 girls, and 88 boys were diagnosed with KD. Coronary artery aneurysms (CAA) at week 6-8 of disease were found in 16% of patients. Boys and infants were more likely to develop aneurysms at the week 6–8 of disease (P = 0.045, P = 0.03, respectively). Their frequency was related to the atypical course (P = 0.02), late diagnosis (P = 0.04), presence of changes in the coronary arteries at the time of diagnosis (P <0.001), immunoglobulin resistance (P = 0.002), a lower hemoglobin value (P <0.001), and a higher platelet value (P = 0.02).

There were 28% of patients with resistance to first-line time treatment. In this group, we found CAA in 31% of children.

Conclusions: We found late diagnosis, low hemoglobin level, high platelet count, CAA presence at diagnosis, atypical course of KD, and resistance to intravenous immunoglobulins are predictors of CAA after 6–8 weeks in KD patients.

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Keywords

acquired heart disease, coronary artery aneurysm, Kawasaki disease, vasculitis

About this article
Title

Clinical characteristics of Kawasaki disease in Polish children: A retrospective study

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-04-04

Page views

54

Article views/downloads

40

DOI

10.33963/KP.a2022.0090

Pubmed

35380006

Keywords

acquired heart disease
coronary artery aneurysm
Kawasaki disease
vasculitis

Authors

Anna Smorczewska-Kiljan
Magdalena Marszał
Joanna Friedman-Gruszczyńska
Anna Wieteska-Klimczak
Janusz Książyk
Maciej Jaworski
Piotr Buda

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