Back to Search
Start Over
Gastrointestinal presentation of kawasaki disease: A red flag for severe disease?
- Source :
- PLoS ONE, Vol 13, Iss 9, p e0202658 (2018)
- Publication Year :
- 2018
-
Abstract
- Background Kawasaki disease (KD) is a febrile systemic vasculitis of unknown etiology and the main cause of acquired heart disease among children in the developed world. To date, abdominal involvement at presentation is not recognized as a risk factor for a more severe form of the disease. Objective To evaluate whether presenting abdominal manifestations identify a group at major risk for Intravenous immunoglobulin (IVIG)-resistance and coronary lesions. Methods Retrospective study of KD patients diagnosed between 2000 and 2015 in 13 pediatric units in Italy. Patients were divided into 2 groups according to the presence or absence of abdominal manifestations at onset. We compared their demographic and clinical data, IVIG-responsiveness, coronary ectasia/aneurysms, laboratory findings from the acute and subacute phases. Results 302 patients (181 boys) were enrolled: 106 patients with, and 196 patients without presenting abdominal features. Seasonality was different between the groups (p = 0.034). Patients with abdominal manifestations were younger (p = 0.006) and more frequently underwent delayed treatment (p = 0.014). In the acute phase, patients with abdominal presentation had higher platelet counts (PLT) (p = 0.042) and lower albuminemia (p = 0.009), while, in the subacute phase, they had higher white blood cell counts (WBC) and PLT (p = 0.002 and p < 0.005, respectively) and lower red blood cell counts (RBC) and hemoglobin (Hb) (p = 0.031 and p 0.009). Moreover, the above mentioned group was more likely to be IVIG-resistant (p < 0.005) and have coronary aneurysms (p = 0.007). In the multivariate analysis, presenting abdominal manifestations, age younger than 6 months, IVIG- resistance, delayed treatment and albumin concentration in the acute phase were independent risk factors for coronary aneurysms (respectively p
- Subjects :
- Male
Genetics and Molecular Biology (all)
Abdominal pain
Heart disease
Drug Resistance
lcsh:Medicine
Gastroenterology
Biochemistry
Cohort Studies
0302 clinical medicine
Risk Factors
Biochemistry, Genetics and Molecular Biology (all)
Agricultural and Biological Sciences (all)
Medicine
030212 general & internal medicine
lcsh:Science
Child
Multidisciplinary
Age Factors
Coronary Aneurysm
Immunoglobulins, Intravenous
medicine.anatomical_structure
Italy
Child, Preschool
Female
medicine.symptom
Systemic vasculitis
Dilatation, Pathologic
medicine.medical_specialty
Vomiting
Socio-culturale
Mucocutaneous Lymph Node Syndrome
03 medical and health sciences
030225 pediatrics
Internal medicine
Humans
Risk factor
Serum Albumin
Retrospective Studies
business.industry
Platelet Count
lcsh:R
Infant
Retrospective cohort study
medicine.disease
Abdominal Pain
Coronary arteries
Etiology
lcsh:Q
Kawasaki disease
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- PLoS ONE, Vol 13, Iss 9, p e0202658 (2018)
- Accession number :
- edsair.doi.dedup.....9e2ed50c567fce330896050aa7d982b4