Scott A Cameron 1 , Michael Carr 1 , Elfriede Pahl 1 , Nicole DeMarais 2 , Stanford T Shulman 3 , Anne H Rowley 3 Show Affiliations »
Abstract
OBJECTIVE: We aimed to compare the severity of coronary artery abnormalities in Kawasaki disease between infants and older children. METHODS: We retrospectively reviewed and compared coronary artery dilation and aneurysm severity in infants <1 year of age with Kawasaki disease at our centre over a 10-year period with that observed in children ≥1 year of age in the Pediatric Heart Network Trial of Pulse Steroid Therapy in Kawasaki Disease. Coronary artery abnormalities were defined by z-scores according to American Heart Association guidelines. RESULTS: Of the 93 infants identified during the study period, 80 were treated with intravenous gamma globulin within the first 10 days of illness and were included for comparison to 170 children ≥1 year of age treated in the same time frame from the Pediatric Heart Network public database. The mean maximum z-score was significantly higher in infants compared with older children (3.37 vs 2.07, p<0.001). A higher incidence of medium and giant aneurysms was observed in infants compared with children ≥1 year of age (11% vs 3% for medium aneurysms, p=0.015; 8% vs <1% for giant aneurysms, p=0.005). CONCLUSIONS: Infants with Kawasaki disease have more severe coronary artery dilation compared with older children, and a higher prevalence of medium and giant aneurysms. Because adverse outcomes are closely linked to the maximal coronary artery diameter in Kawasaki disease, patients diagnosed as infants require very close long-term monitoring for cardiac complications. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVE: We aimed to compare the severity of coronary artery abnormalities in Kawasaki disease between infants and older children . METHODS: We retrospectively reviewed and compared coronary artery dilation and aneurysm severity in infants <1 year of age with Kawasaki disease at our centre over a 10-year period with that observed in children ≥1 year of age in the Pediatric Heart Network Trial of Pulse Steroid Therapy in Kawasaki Disease . Coronary artery abnormalities were defined by z-scores according to American Heart Association guidelines. RESULTS: Of the 93 infants identified during the study period, 80 were treated with intravenous gamma globulin within the first 10 days of illness and were included for comparison to 170 children ≥1 year of age treated in the same time frame from the Pediatric Heart Network public database. The mean maximum z-score was significantly higher in infants compared with older children (3.37 vs 2.07, p<0.001). A higher incidence of medium and giant aneurysms was observed in infants compared with children ≥1 year of age (11% vs 3% for medium aneurysms , p=0.015; 8% vs <1% for giant aneurysms , p=0.005). CONCLUSIONS: Infants with Kawasaki disease have more severe coronary artery dilation compared with older children , and a higher prevalence of medium and giant aneurysms . Because adverse outcomes are closely linked to the maximal coronary artery diameter in Kawasaki disease , patients diagnosed as infants require very close long-term monitoring for cardiac complications . © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
cardiology; infectious diseases; vascular disease
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Year: 2018
PMID： 30413485 DOI： 10.1136/archdischild-2018-314967
Source DB: PubMed Journal: Arch Dis Child ISSN： 0003-9888 Impact factor: 3.791