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Kawasaki disease: review of risk factors for coronary aneurysms
Insights
Kawasaki disease can lead to coronary artery aneurysms, particularly with prolonged fever. Early fever duration is a key predictor, similar to the modified Asai score.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Kawasaki disease is a leading cause of acquired heart disease in children.
- Coronary artery aneurysms are a significant complication, necessitating identification of predictive factors.
Purpose of the Study:
- To investigate predictors of coronary artery aneurysm development in pediatric patients diagnosed with Kawasaki disease.
- To compare the predictive value of fever duration with the modified Asai score for coronary artery involvement.
Main Methods:
- Retrospective analysis of 163 pediatric patients diagnosed with Kawasaki disease between 1979 and 1984.
- Data collected included patient demographics, fever duration, medication use (aspirin, acetaminophen), and occurrence of coronary artery aneurysms.
- Statistical analysis to compare characteristics between patients with and without coronary aneurysms.
Main Results:
- Fifteen percent of patients developed coronary artery aneurysms.
- Higher temperatures during days 10-13 and longer fever duration (>= 14 days) were significantly associated with coronary aneurysms.
- Fever duration was as predictive of coronary aneurysms as the modified Asai score.
- Coronary artery involvement occurred equally in boys and girls and was not significantly higher in infants under one year.
Conclusions:
- Prolonged fever and higher temperature in the later febrile phase are significant indicators of coronary artery aneurysm risk in Kawasaki disease.
- Fever duration is a valuable and accessible predictor of coronary artery complications.
- This highlights the importance of monitoring fever patterns in Kawasaki disease management.
Abstract:
Between June 1, 1979, and May 31, 1984, at The Hospital for Sick Children in Toronto, Kawasaki disease was diagnosed in 163 patients (112 boys, 51 girls, P less than 0.001). Fifteen percent of the children had coronary artery aneurysms. Prior to diagnosis, 24% had been given low doses of aspirin, and 50% acetaminophen. Children with coronary aneurysms had significantly higher temperature during days 10 to 13 of the disease. The febrile phase of the disease was also significantly longer in these children. Coronary artery involvement occurred with equal frequency in boys and girls. There was no significantly greater incidence of coronary artery involvement in infants younger than 1 year of age than in older children. Duration of fever (greater than or equal to 14 days vs less than 14 days) was equally as predictive of the eventual occurrence of coronary aneurysms as the modified Asai score.