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Late development of coronary artery abnormalities could be associated with persistence of non-fever symptoms in Kawasaki disease
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نویسنده
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fukuda s. ,ito s. ,oana s. ,sakai h. ,kato h. ,abe j. ,ito r. ,saitoh a. ,takayama j.i.
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منبع
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pediatric rheumatology - 2013 - دوره : 11 - شماره : 1
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چکیده
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Background: persistent fever after intravenous immunoglobulin (ivig) is considered to be a major criterion of ivig resistance in kawasaki disease (kd),and a risk factor for the development of coronary artery abnormalities (caa). however,the importance of persistent non-fever symptoms after defervescence has not yet been investigated. we examined the relationship between persistent non-fever symptoms and caa in kd.methods: we conducted a retrospective cohort study of patients hospitalized with kd at the national center for child health and development between 1 april 2008 and 31 march 2009. patients were divided into two groups; group a included patients who still had non-fever symptoms one month after onset of the illness and group b included patients who did not have persistent non-fever symptoms. demographic,clinical variables were compared between the groups.results: seventy-seven kd patients treated with ivig were retrospectively analyzed. patients were divided into two groups; group a included 12 (15.6%) patients and group b 65 (84.4%) patients. demographic data,baseline laboratory data,and fever duration did not differ between the groups. in group a patients the most common persistent non-fever symptoms were lip erythema (n = 6) and bulbar conjunctivitis (n = 8). one month after onset of the illness caa developed in seven of 77 patients (9.1%),four (33%) in group a and three (4.6%) in group b (odds ratio 10.3; 95% ci 1.9-54.8). three patients in group a and one patient in group b developed caa after the resolution of fever.conclusions: persistence of non-fever symptoms after ivig may suggest persistence of latent inflammation,which may increase the risk of caa. therefore,patients with persistent non-fever symptoms may be at risk of developing caa,even after defervescence. a prospective trial of additional ivig for such patients should be considered. © 2013 fukuda et al.; licensee biomed central ltd.
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کلیدواژه
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Coronary artery abnormalities; Fever; Intravenous immunoglobulin; Kawasaki disease
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آدرس
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department of general pediatrics and interdisciplinary medicine,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo 157-8535, Japan, division of nephrology and rheumatology,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo, Japan, department of general pediatrics and interdisciplinary medicine,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo 157-8535, Japan, department of general pediatrics and interdisciplinary medicine,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo 157-8535, Japan, division of cardiology,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo, Japan, department of allergy and immunology,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo, Japan, department of health policy,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo, Japan, division of infectious disease,national research center for child health and development,national center for child health and development,2-10-1 okura,setagaya-ku,tokyo,japan,department of pediatrics,niigata university,graduate school of medical and dental sciences,1-757 asahi-machi,chuo-ku,niigata, Japan, department of pediatrics,university of california san francisco,400 parnassus avenue,san francisco,ca, United States
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Authors
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