Related Experiment Video
Updated: Aug 4, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Complete and incomplete Kawasaki disease: Clinical differences and coronary artery outcome from a national
S Bressieux-Degueldre1, E Gradoux2, S Di Bernardo1
1Pediatric Cardiology Unit, Department of Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
Insights
Kawasaki disease (KD) in children presents differently based on completeness, but coronary artery outcomes are similar. Corticosteroids may prevent aneurysms, though regression is slower in incomplete KD cases.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease (KD) is a critical pediatric illness affecting coronary arteries.
- Distinguishing between complete and incomplete KD is essential for management and prognosis.
- Coronary artery abnormalities are a major concern in KD patients.
Purpose of the Study:
- To compare clinical presentation, laboratory findings, treatment, and coronary artery outcomes in children with complete versus incomplete Kawasaki disease.
- To evaluate the long-term effects of KD on coronary arteries in different disease classifications.
- To assess the role of specific treatments, like corticosteroids, in managing KD complications.
Main Methods:
- A prospective surveillance study involving 351 children diagnosed with KD in Switzerland between March 2013 and February 2019.
- Collection of clinical data, laboratory values, treatment details, and echocardiographic features at diagnosis and 1-year follow-up.
- Comparative analysis of data between children with complete KD and incomplete KD.
Main Results:
- Incomplete KD patients were younger and had longer fever duration, but similar C-reactive protein levels compared to complete KD.
- Corticosteroid treatment was more frequent in incomplete KD patients (p=0.01).
- Coronary artery involvement (dilation or aneurysm) was observed in 16.2% at diagnosis and 5.8% at follow-up, with no significant difference between groups initially, but a slight increase in aneurysms at follow-up for incomplete KD (p=0.039).
Conclusions:
- Clinical presentation differs between complete and incomplete Kawasaki disease, but coronary artery outcomes are comparable at diagnosis.
- Corticosteroid use may be protective against coronary artery aneurysm development.
- Incomplete KD patients may have a lower rate of coronary artery aneurysm regression, warranting further investigation.
Introduction:
The aim of this national prospective surveillance study was to compare the clinical presentation, laboratory findings, treatment, and coronary artery outcome in patients with incomplete and complete Kawasaki disease (KD).
Methods:
Between March 2013 and February 2019, children with a diagnosis of complete and incomplete KD were reported by the Swiss Paediatric Surveillance Unit and prospectively enrolled. Clinical data, laboratory values, treatment, and echocardiographic features were collected at diagnosis and 1 year of follow-up. Data were compared between children with complete or incomplete KD.
Results:
A total of 351 questionnaires were registered from children with a diagnosis of KD. Of them, 219 (62.4%) children had complete KD, and 132 (37.6%) children had incomplete KD. Children with incomplete KD were younger and had a longer-lasting fever; however, there were no differences in the level of C-reactive protein. All but four children received intravenous immunoglobulin treatment, whereas 14% of children were treated with corticosteroids. Children with incomplete KD were more often treated with corticosteroids than children with incomplete KD (p = 0.01). At diagnosis, 39 (11.1%) patients had only coronary artery dilation and 57 (16.2%) had at least one coronary artery aneurysm. There were no differences in coronary artery involvement between the two groups. At follow-up, 273 of 294 (92.8%) patients had no coronary artery involvement, with no difference between the two groups (p = 0.609). The overall incidence of coronary artery aneurysms at diagnosis was 16.2%. At follow-up, most coronary artery aneurysms had regressed, and coronary artery aneurysms were present in only 5.8% of the patients. Coronary artery aneurysms were slightly more frequent in patients with incomplete KD at follow-up (p = 0.039) but not at diagnosis (p = 0.208).
Conclusion:
Although the clinical presentation in children with incomplete and complete KD differs, the absence of coronary artery involvement does not. The use of corticosteroids appears to be preventive against the development of coronary artery aneurysms in these patients. However, the results of this study suggest a lower rate of coronary artery aneurysm regression in patients with incomplete KD. Further studies on a larger scale are needed to assess the risk of non-regression of coronary artery aneurysms in this particular group of patients.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care