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Coronary Lesions and Systemic Inflammatory Response Syndrome in Kawasaki Disease
Yutaro Tomobe1, Osamu Nomura2, Yoshihiko Morikawa3
1Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Insights
Systemic inflammatory response syndrome (SIRS) is a risk factor for coronary artery lesions (CALs) in Kawasaki disease (KD). Early identification of SIRS in KD patients may help prevent CAL development.
Area of Science:
- Pediatrics
- Immunology
- Cardiology
Background:
- Kawasaki disease (KD) can lead to coronary artery lesions (CALs) due to hypercytokinemia.
- Systemic inflammatory response syndrome (SIRS) is an indicator of hypercytokinemia in KD patients.
Purpose of the Study:
- To investigate the association between SIRS and the formation of CALs in patients with Kawasaki disease.
Main Methods:
- A retrospective cohort study included 277 KD patients.
- Patients were categorized into SIRS and non-SIRS groups based on clinical and laboratory findings.
- CAL incidence was compared between the groups.
Main Results:
- The SIRS group showed a significantly higher incidence of CAL formation at week 1 (17.7%) and one month (10.9%) compared to the non-SIRS group.
- SIRS was identified as an independent risk factor for CAL formation at week 1 (OR, 2.7; P=0.04).
Conclusions:
- SIRS is a significant risk factor for developing coronary artery lesions in the acute phase of Kawasaki disease.
- SIRS may serve as a valuable clinical marker for predicting CAL development in KD patients.
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.
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