Coronary lesion in Kawasaki disease in children

ABSTRACT

Background: Kawasaki is an acute fever disease with systematic vein infection and often seen in children.Objectives:This study aims to determine features and risk factors of coronary artery lesion (CAL) in Kawasaki disease in children. Subjects and method:A descriptive, prospective study was conducted on 83 patients diagnosed with Kawasaki disease whom treated at National Hospital for Pediatric from January 2005 to March 2007. They were divided into 2 groups with and without CAL. All data from clinical characteristics, laboratory and echocardiography were analyzed to evaluate the differences between 2 groups. Univariate and multivariate analysis were used. Results: Among 83 patients diagnosed with Kawasaki disease, 27 patients (32.5%) was found with CAL. 24 patients (88.9%) had both right and left coronary artery abnormalities. The CAL in left anterior descending (LAD) and in left circumflex coronary artery (LCX) was 55.6% and 25.9% respectively. Risk level II 7 patients (25.9%). Risk level III 14 patients (51.9%) and risk level IV 6 patients (22.2%). 14 patients (51.9%) with CAL were resolved at 6th month of the illness. Independent risk factors of CAL in acute stage included age under 12 months (OR = 3.97, p<0.05). IVIG treatment was within the first 10 day of the illness (OR=0.25, p<0.05). Non - responsiveness to \u03b3globulin therapy (OR=7.69, p<0.01). CRP before starting initial treatment above 90mg/1 (OR = 12.81, p<0.05). Platelets before starting \u03b3 globulin therapy ~ 557 000/ mm3 with OR=4.73 and p<0.05. Conclusion:Early detection and treatment were necessary in order to decrease CAL in patients with Kawasaki disease.