Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-08T07:19:17.463Z Has data issue: false hasContentIssue false
  • English
  • Français

Giant coronary artery aneurysms complicating Kawasaki disease in Mexican children

Published online by Cambridge University Press:  29 August 2017

Luis M. Garrido-García ,
Edna Morán-Villaseñor ,
Marco A. Yamazaki-Nakashimada ,
Patricia Cravioto  and
Fernando Galván
Luis M. Garrido-García*
Affiliation:
Cardiology Department, National Institute of Paediatrics, Mexico City, Mexico
Edna Morán-Villaseñor
Affiliation:
Dermatology Department, National Institute of Paediatrics, Mexico City, Mexico
Marco A. Yamazaki-Nakashimada
Affiliation:
Immunology Department, National Institute of Paediatrics, Mexico City, Mexico
Patricia Cravioto
Affiliation:
Teaching Department, National Institute of Paediatrics, Mexico City, Mexico
Fernando Galván
Affiliation:
Teaching Department, National Institute of Paediatrics, Mexico City, Mexico
*
Correspondence to: L. M. Garrido-García, MD, MSc, Cardiology Department, National Institute of Paediatrics, Av. Insurgentes Sur 3700-C, Colonia Insurgentes Cuicuilco, Mexico City, 04530, Mexico. Tel: +52 551 353 7829; Fax: + 52 55 10840900; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

One of the most important complications of Kawasaki disease is the development of giant coronary aneurysms. Risk factors for their development are still not clear.

Methods

A retrospective analysis was conducted at the National Institute of Paediatrics in Mexico City, Mexico. It included all patients with a diagnosis of acute Kawasaki disease between August, 1995 and August, 2015. Clinical and laboratory findings, as well as echocardiographic measurements, were recorded. Patients with giant coronary aneurysms (z-score⩾10) were compared with the rest of the patients. A value of p<0.05 was considered statistically significant. Odds ratios and their 95% confidence intervals were calculated to define risk factors.

Results

During the study period, 416 patients were diagnosed with Kawasaki disease. Of them, 34 developed giant coronary aneurysms during the acute stage of the disease. In the multivariate analysis, patients younger than 1 year, those with a higher duration of illness at the time of diagnosis, and those who received additional intravenous immunoglobulin showed a significantly higher frequency of giant coronary aneurysms.

Conclusions

One of the main factors associated with the development of giant coronary aneurysms was the delay in the diagnosis of Kawasaki disease. This finding highlights the importance of maintaining a high suspicion of the disease, which would enable an early diagnosis and prompt treatment and decrease the risk for developing giant coronary aneurysms.

Keywords

Kawasaki diseasegiant coronary aneurysmsrisk factors
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 3 , March 2018 , pp. 386 - 390
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Newburger, JW, Takahashi, M, Gerber, MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease. Circulation 2004; 110: 2747–2771.Google Scholar
2. Son, MBF, Newburger, JW. Kawasaki disease. Pediatr Rev 2013; 34: 151–161.Google Scholar
3. Newburger, JW, Takahashi, M, Burns, JC. Kawasaki disease. JACC 2016; 67: 1738–1749.Google Scholar
4. Makino, N, Nakamura, Y, Yashiro, M, et al. Descriptive epidemiology of Kawasaki disease in Japan, 2011–2012: from the results of the 22nd Nationwide survey. J Epidemiol 2015; 25: 239–245.Google Scholar
5. Sudo, D, Monobe, Y, Yashiro, M, et al. Case-control study of giant coronary aneurysms due to Kawasaki disease: the 19th nationwide survey. Pediatr Int 2010; 52: 790–794.Google Scholar
6. Nakamura, Y, Yashiro, M, Oki, I, et al. Giant coronary aneurysms due to Kawasaki disease: a case-control study. Pediatr Int 2002; 44: 254–258.Google Scholar
7. Nakamura, Y, Yashiro, M, Uehara, R, et al. Case-control study of giant coronary aneurysms due to Kawasaki disease. Pediatr Int 2003; 45: 410–413.Google Scholar
8. Nakamura, Y, Yashiro, M, Uehara, R, et al. Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease. Pediatr Int 2004; 46: 33–38.Google Scholar
9. Dallaire, F, Dahdah, N. New equations and a critical appraisal of coronary artery Z scores in healthy children. J Am Soc Echocardiogr 2011; 24: 60–74.Google Scholar
10. Manlhiot, C, Millar, K, Golding, F, McCrindle, BW. Improved classification of coronary artery abnormalities based only on coronary artery z-scores after Kawasaki disease. Pediatr Cardiol 2010; 31: 242–249.Google Scholar
11. Uehara, R, Belay, ED. Epidemiology of Kawasaki disease in Asia, Europe, and the United States. J Epidemiol 2012; 22: 79–85.Google Scholar
12. Budnik, OI, Hirsch, BT, Fernández, CC, Yánez, PL, Zamorano, RJ. Enfermedad de Kawasaki: una serie clínica. Rev Chil Infect 2011; 28: 416–422.Google Scholar
13. Martínez-Ruíz, M, del Castillo, MF, Borque, AC, et al. Incidencia y características clínicas de la enfermedad de Kawasaki. Ann Pediatr (Barc) 2003; 59: 323–327.Google Scholar
14. Garrido-García, LM, Soto-Blanquel, JL, Espinosa-Rosales, FJ. Enfermedad de Kawasaki: cuadro clínico, exámenes de laboratorio y lesiones coronarias. Acta Pediatr Mex 2015; 36: 314–321.Google Scholar
15. Kim, J-J, Hong, YM, Yun, SW, et al. Assessment of risk factors for Korean children with Kawasaki disease. Pediatr Cardiol 2012; 33: 513–520.Google Scholar
16. Lee, J, Kim, GB, Kwon, BS, Bae, EJ, Noh, CI. Two cases of super-giant coronary aneurysms after Kawasaki disease. Korean Circ J 2014; 44: 54–58.Google Scholar
17. Schroh, AM, Domínguez, P, Laghezza, LB, et al. Enfermedad de Kawasaki: afección cardiaca durante la infancia. Rev Esp Cardiol 2006; 59: 387–390.Google Scholar
18. Morikawa, Y, Ohashi, Y, Harada, K, et al. Coronary risks after high-dose gamma-globulin in children with Kawasaki disease. Pediatr Int 2000; 42: 464–469.Google Scholar
19. Ha, KS, Jang, GY, Lee, JH, et al. Incomplete clinical manifestation as a risk for coronary artery abnormalities in Kawasaki disease: a meta-analysis. Eur J Pediatr 2013; 172: 343–349.Google Scholar
20. Lin, MC, Hsu, CM, Fu, YC. Giant coronary aneurysms developed in a child of Kawasaki disease with only 3 days of fever. Cardiol Young 2010; 20: 339–341.Google Scholar
21. Samada, K, Shiraishi, H, Sato, A, Momoi, MY. Grown-up Kawasaki disease patients who have giant coronary aneurysms. World J Pediatr 2010; 6: 38–42.Google Scholar
22. Al-Mashham, Y, Sinclair, BG, Duncan, WJ. Giant coronary arterial aneurysms and thrombosis in an infant with Kawasaki disease. Cardiol Young 2006; 16: 510.Google Scholar
23. Patil, S, Shirodkar, S, Pinto, RJ, Dalvi, B. Giant coronary artery aneurysm with a thrombus secondary to Kawasaki disease. Ann Pediatr Cardiol 2008; 1: 59–61.Google Scholar
24. Lega, JC, Bozio, A, Cimaz, R, et al. Extracoronary echocardiographic findings as predictors of coronary artery lesions in the initial phase of Kawasaki disease. Arch Dis Child 2012; 0: 1–6.Google Scholar