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Giant aneurysms: A gender-specific complication of Kawasaki disease?

Sanne M Dietz1, Irene M Kuipers2, Carline E A Tacke1

  • 1Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands.

Journal of Cardiology
|March 23, 2017
PubMed

Insights

Male gender, young age, and IVIG retreatment increase the risk of giant coronary artery aneurysms in Kawasaki disease. Early and repeated echocardiography is crucial for monitoring disease progression.

Area of Science:

  • Pediatric Cardiology
  • Vasculitis Research
  • Medical Diagnostics

Background:

  • Kawasaki disease (KD) is a pediatric vasculitis with unknown etiology.
  • Coronary artery aneurysms (CAA) are a primary complication, with giant CAA representing the most severe form.
  • Identifying risk factors for giant CAA is critical for timely intervention.

Purpose of the Study:

  • To evaluate patient characteristics associated with the development of giant CAA in Kawasaki disease.
  • To identify predictors of giant CAA using z-score analysis.
  • To differentiate risk factors for giant CAA from other CAA sizes.

Main Methods:

  • Retrospective cohort study of 301 Kawasaki disease patients.
  • Analysis of echocardiographic data to categorize CAA size (none, small, medium, giant).
  • Multivariable, multinomial logistic regression to identify risk factors for giant CAA.

Main Results:

  • Male gender, age under 1 year, and IVIG re-treatment were significantly associated with increased risk of giant CAA.
  • 95% of patients with giant CAA were male.
  • Giant CAA often continued to increase in size within the first 40 days.

Conclusions:

  • Male gender, younger age, and IVIG re-treatment are key risk factors for giant CAA.
  • Giant CAA may represent a distinct, treatment-resistant subgroup of KD.
  • Repeated echocardiography is recommended in the first two months to monitor CAA growth.
Abstract

Keywords:
(Giant) coronary aneurysmsKawasaki diseaseRisk factors

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