Yutaro Tomobe1, Osamu Nomura2, Yoshihiko Morikawa3, Nobuaki Inoue2, Hiroshi Sakakibara1, Masaru Miura3,4. 1. Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 2. Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 3. Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 4. Department of Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Abstract
INTRODUCTION: In patients with Kawasaki disease (KD), who later develop coronary artery lesions (CALs), several inflammatory cytokines are reportedly higher than in patients without CALs. Systemic inflammatory response syndrome (SIRS) is used as a clinical index of hypercytokinemia. The objective of this study was to determine whether SIRS is related to CAL formation. METHODS: We conducted a retrospective cohort study of KD patients admitted to our hospital between July 2012 and July 2015. The subjects were classified into the SIRS or the non-SIRS group based on their vital signs and blood test results. Their initial treatment was determined by their Kobayashi score. We compared the incidence of CALs between the two groups. RESULTS: Of 357 KD patients, 277 were included in this study and 175 (63.2%) met the SIRS criteria. The incidence of CAL formation at week 1 in the clinical course and at one month after the primary treatment was significantly higher in the SIRS group than in the non-SIRS group (17.7% vs. 7.8%, p = 0.03 and 10.9% vs. 3.9%, p = 0.03, respectively). Multivariate analyses showed that after adjusting for each variable of the Kobayashi score, SIRS was an independent risk factor for CAL formation at week 1 in the clinical course (odds ratio, 2.7; 95% confidence interval, 1.03-7.23; p = 0.04). CONCLUSIONS: SIRS can be a risk factor for CAL in the acute phase of KD.
INTRODUCTION: In patients with Kawasaki disease (KD), who later develop coronary artery lesions (CALs), several inflammatory cytokines are reportedly higher than in patients without CALs. Systemic inflammatory response syndrome (SIRS) is used as a clinical index of hypercytokinemia. The objective of this study was to determine whether SIRS is related to CAL formation. METHODS: We conducted a retrospective cohort study of KD patients admitted to our hospital between July 2012 and July 2015. The subjects were classified into the SIRS or the non-SIRS group based on their vital signs and blood test results. Their initial treatment was determined by their Kobayashi score. We compared the incidence of CALs between the two groups. RESULTS: Of 357 KD patients, 277 were included in this study and 175 (63.2%) met the SIRS criteria. The incidence of CAL formation at week 1 in the clinical course and at one month after the primary treatment was significantly higher in the SIRS group than in the non-SIRS group (17.7% vs. 7.8%, p = 0.03 and 10.9% vs. 3.9%, p = 0.03, respectively). Multivariate analyses showed that after adjusting for each variable of the Kobayashi score, SIRS was an independent risk factor for CAL formation at week 1 in the clinical course (odds ratio, 2.7; 95% confidence interval, 1.03-7.23; p = 0.04). CONCLUSIONS: SIRS can be a risk factor for CAL in the acute phase of KD.
Authors: Lynn A Sleeper; L Luann Minich; Brian M McCrindle; Jennifer S Li; Wilbert Mason; Steven D Colan; Andrew M Atz; Beth F Printz; Annette Baker; Victoria L Vetter; Jane W Newburger Journal: J Pediatr Date: 2010-12-18 Impact factor: 4.406
Authors: Jane W Newburger; Masato Takahashi; Michael A Gerber; Michael H Gewitz; Lloyd Y Tani; Jane C Burns; Stanford T Shulman; Ann F Bolger; Patricia Ferrieri; Robert S Baltimore; Walter R Wilson; Larry M Baddour; Matthew E Levison; Thomas J Pallasch; Donald A Falace; Kathryn A Taubert Journal: Circulation Date: 2004-10-26 Impact factor: 29.690