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Assessment of risk factors for Korean children with Kawasaki disease

Jae-Jung Kim1, Young Mi Hong, Sin Weon Yun

  • 1Asan Institute for Life Sciences, University of Ulsan College of Medicine, 388-1 Pungnap-2-Dong, Songpa-Gu, Seoul 138-736, Korea.

Pediatric Cardiology
|November 23, 2011
PubMed

Insights

Kawasaki disease patients with incomplete symptoms, prolonged fever, or a specific PELI1 gene variant face higher risks of coronary artery lesions. Low serum albumin is linked to poor response to standard IVIG therapy.

Area of Science:

  • Pediatric Cardiology
  • Genetics
  • Immunology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Standard treatment with intravenous immunoglobulin (IVIG) is ineffective in over 10% of patients, increasing their risk of coronary artery lesions (CALs).

Purpose of the Study:

  • To identify clinical and genetic factors predicting CAL development and IVIG nonresponsiveness in Korean KD patients.

Main Methods:

  • Analysis of clinical data from 478 Korean KD patients.
  • Multivariate logistic regression to assess risk factors for CALs and IVIG nonresponsiveness.

Main Results:

  • Incomplete KD, IVIG nonresponse, fever lasting ≥7 days, and PELI1 rs7604693 genotypes (CC/AC) were significant risk factors for CALs (ORs 2.06-3.04).
  • Low serum albumin (<3.6 g/dL) was independently associated with IVIG nonresponsiveness (OR 2.76).

Conclusions:

  • Incomplete KD, IVIG nonresponsiveness, prolonged fever, and the PELI1 rs7604693 variant are key predictors of CAL development.
  • Low serum albumin is an independent risk factor for treatment failure in Kawasaki disease.

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