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The Risk Prediction of Coronary Artery Lesions through the Novel Hematological Z-Values in 4 Chronological Age Subgroups of Kawasaki Disease
- Source :
- Medicina, Volume 56, Issue 9, Medicina; Volume 56; Issue 9; Pages: 466, Medicina, Vol 56, Iss 466, p 466 (2020)
- Publication Year :
- 2020
- Publisher :
- MDPI AG, 2020.
-
Abstract
- Background and Objectives: Most cases of Kawasaki disease (KD) occur between the ages of 6 months and 5 years. Differences in immunological reaction and CAL (coronary artery lesion) by the age subgroups classified according to the prevalence of KD and those particularly in the earlier life of KD should be investigated. Materials and Methods: The laboratory data of 223 infantile and 681 non-infantile KD cases from 2003 to 2018 at Korea University Hospital were retrospectively analyzed. Patients with KD were divided into infants and non-infants and further subdivided into four subgroups by age. The age-adjusted Z-values were compared among the subgroups. Febrile controls were identified as patients with fever for &gt<br />5 days and who showed some of the KD symptoms. Results: IVIG (intravenous immunoglobulin) resistance at the age of 6 months or less was significantly lower than that at the ages of 7&ndash<br />12 months and 13&ndash<br />60 months (respectively, p &lt<br />0.05). The significant risk factors for CAL in total KD patients were age, incomplete KD, post-IVIG fever, IVIG resistance, convalescent Z-eosinophil, and subacute platelet (p &lt<br />0.05). The significant risk factors for CAL at the age of 6 months or less were IVIG resistance, acute Z-neutrophil, subacute Z-neutrophil, subacute NLR (neutrophil to lymphocyte ratio), and subacute platelet (respectively, p &lt<br />0.05). Conclusion: Younger age and incomplete presentation in KD can be independent risk factors for CAL. The immune reactions of KD at a younger age are more tolerated compared with those at older ages during the acute phase. The immune response at the age of 6 months or less showed immune tolerance in terms of incomplete presentation and IVIG responsiveness. The risk factors such as IVIG resistance, subacute platelet, subacute NLR, and acute or subacute Z-neutrophil at the age of 6 months or less can be very useful parameters to predict CAL in young, incomplete KD.
- Subjects :
- leukocyte count
medicine.medical_specialty
age distribution
Mucocutaneous Lymph Node Syndrome
030204 cardiovascular system & hematology
Gastroenterology
Article
Immune tolerance
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Immune system
Internal medicine
Republic of Korea
medicine
Humans
Platelet
Neutrophil to lymphocyte ratio
Aged
Retrospective Studies
lcsh:R5-920
Kawasaki disease
biology
business.industry
Immunoglobulins, Intravenous
Infant
General Medicine
Middle Aged
hemoglobin
medicine.disease
medicine.anatomical_structure
biology.protein
Antibody
lcsh:Medicine (General)
business
coronary artery disease
030217 neurology & neurosurgery
Artery
Subjects
Details
- ISSN :
- 16489144
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Medicina
- Accession number :
- edsair.doi.dedup.....7ed7ae917f192af01ebbfa285dcbaebe
- Full Text :
- https://doi.org/10.3390/medicina56090466