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Laboratory Markers in Incomplete Kawasaki Disease according to Coronary Artery Outcome
Kee Soo Ha1, Gi Young Jang2, JungHwa Lee3
1Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea.
Insights
Laboratory markers in incomplete Kawasaki disease (iKD) patients show similarities to complete Kawasaki disease (cKD). However, lower hemoglobin levels predict coronary dilation specifically in iKD patients, unlike in cKD.
Area of Science:
- Pediatrics
- Rheumatology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is a critical pediatric illness affecting blood vessels.
- Incomplete KD (iKD) presents diagnostic challenges, particularly regarding coronary artery abnormalities.
- Identifying specific laboratory markers for iKD is crucial for timely intervention.
Purpose of the Study:
- To define laboratory marker profiles characteristic of iKD.
- To investigate the association between these markers and coronary artery abnormalities.
- To compare laboratory findings in iKD, complete KD (cKD), and febrile controls.
Main Methods:
- Retrospective analysis of clinical and laboratory data from 795 patients.
- Categorization into iKD (178), cKD (504), and febrile controls (113).
- Evaluation of hemoglobin, platelet counts, and neutrophil-to-lymphocyte ratio over time.
Main Results:
- Hemoglobin and platelet count trends differed between KD patients (iKD and cKD) and controls.
- Lower acute and subacute hemoglobin levels were associated with coronary dilation in iKD patients (OR 0.538-0.583).
- Higher subacute platelet counts (OR 1.004) and acute neutrophil-to-lymphocyte ratio (OR 1.059) were linked to coronary dilation/aneurysm in cKD patients.
Conclusions:
- iKD patients exhibit KD-specific complete blood cell count and acute phase reactant profiles similar to cKD patients.
- Predictors of coronary dilation vary between iKD and cKD phenotypes.
- Lower hemoglobin levels are a significant predictor of coronary dilation exclusively in iKD patients.
Background And Objectives:
We defined laboratory marker profiles typical of incomplete Kawasaki disease (iKD) during illness, especially with respect to the presence of a coronary artery abnormality such as coronary artery dilation or aneurysm.
Methods:
This retrospective study examined the clinical and laboratory markers of patients with iKD over time, along with those of patients with complete KD (cKD) and febrile controls.
Results:
Of 795 patients, 178 had iKD, 504 had cKD and 113 were febrile controls. During the transition from the acute to subacute phase, the age-adjusted hemoglobin levels and platelet counts were significantly lower and higher, respectively, in the subacute phase than in the acute phase in both iKD and cKD patients, which differed from those of febrile controls. Lower levels of acute and subacute age-adjusted hemoglobin levels in iKD patients (odds ratio [OR], 0.538 and 0.583; p=0.006 and 0.018, respectively) and higher subacute platelet counts in cKD patients (OR, 1.004; p=0.014) were correlated with the risk of coronary dilation. A higher acute neutrophil-to-lymphocyte ratio was associated with aneurysm only in cKD patients (OR, 1.059; p=0.044).
Conclusions:
The iKD patients share KD-specific laboratory marker profiles in terms of complete blood cell counts and acute phase reactant levels with cKD patients. However, the factors predicting coronary dilation differ according to the phenotype; lower acute and subacute age-adjusted hemoglobin levels predict coronary dilation only in iKD patients.
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