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Gastrointestinal abnormalities as predictors of cardiovascular involvement in Kawasaki disease: a 5-year

Seyed Hesamedin Nabavizadeh1, Naser Honar2, Sobhan Keshavarz3

  • 1Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

BMC Pediatrics
|July 18, 2026
PubMed

Insights

Gastrointestinal laboratory abnormalities in children with Kawasaki disease (KD) are linked to heart problems. Early identification of high-risk patients, especially males with specific lab results, aids in cardiac surveillance.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Rheumatology
  • Vascular Biology

Background:

  • Kawasaki disease (KD) is a childhood vasculitis with potential cardiovascular complications.
  • Gastrointestinal symptoms and lab abnormalities are frequent in KD but their link to cardiac issues is unclear.
  • This study investigates the association between GI findings and echocardiographic outcomes in pediatric KD.

Purpose of the Study:

  • To determine the relationship between gastrointestinal-related laboratory and imaging findings and echocardiographic outcomes in pediatric Kawasaki disease.
  • To identify specific clinical and laboratory markers associated with cardiovascular involvement in KD.

Main Methods:

  • Retrospective study of 258 children with KD (2019-2024).
  • Collected demographic, clinical, laboratory, echocardiography, and abdominal ultrasonography data.
  • Used univariate and multivariate logistic regression to analyze cardiovascular involvement predictors.

Main Results:

  • 70.7% of patients had abnormal echocardiographic findings.
  • Coronary artery aneurysms (9.8%) and dilatation (9.4%) were observed.
  • Male sex, anemia, hypoalbuminemia, elevated alkaline phosphatase, elevated CRP, and prolonged PTT were independent factors for cardiovascular involvement.

Conclusions:

  • Gastrointestinal laboratory abnormalities significantly correlate with cardiovascular involvement in pediatric KD.
  • Early recognition of high-risk factors (male sex, anemia, hypoalbuminemia, inflammation, liver enzyme abnormalities) can guide risk stratification and cardiac monitoring.
  • Intensified cardiac surveillance in the acute phase is recommended for at-risk KD patients.
Abstract

Keywords:
Coronary arteryEchocardiographyGastrointestinalKawasaki diseaseVasculitis

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