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Can Coronary Artery Involvement in Kawasaki Disease be Predicted?
Division of Cardiology, Children's National Medical Center, Washington, DC 20010, USA
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA
Current address: Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA
* Author to whom correspondence should be addressed.
Received: 1 February 2013; in revised form: 12 March 2013 / Accepted: 21 March 2013 / Published: 26 March 2013
Abstract: Background: Coronary artery involvement is seen in approximately 15–20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature. Methods and results: A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High erythrocyte sedimentation rate and refractory Kawasaki disease were found to be independent predictors of coronary artery involvement. Review of literature suggested a wide range of coronary involvement (<5% to >60%), and highly conflicting clinical and laboratory associations. Conclusion: It remains difficult to accurately determine risk of coronary artery involvement, although some laboratory markers may provide information that is helpful for parental counseling and clinical follow up. Future identification of novel biomarkers and host predispositions may further our understanding of coronary artery risks and help personalize therapy for Kawasaki disease.
Keywords: Kawasaki disease; vasculitis; muco-cutaneous lymph node syndrome
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MDPI and ACS Style
Ghelani, S.J.; Kwatra, N.S.; Spurney, C.F. Can Coronary Artery Involvement in Kawasaki Disease be Predicted? Diagnostics 2013, 3, 232-243.
Ghelani SJ, Kwatra NS, Spurney CF. Can Coronary Artery Involvement in Kawasaki Disease be Predicted? Diagnostics. 2013; 3(2):232-243.
Ghelani, Sunil J.; Kwatra, Neha S.; Spurney, Christopher F. 2013. "Can Coronary Artery Involvement in Kawasaki Disease be Predicted?" Diagnostics 3, no. 2: 232-243.