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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Preventing coronary artery abnormalities: A need for earlier diagnosis and treatment of Kawasaki disease
Pediatric Infectious Disease Journal, Volume 31, No. 12, Year 2012
Notification
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Description
OBJECTIVES: The aim of this study was to explore the timing of coronary artery (CA) abnormalities in light of the expanding clinical spectrum of Kawasaki disease (KD). METHODS: We reviewed all cases of KD admitted to Children's Hospital Colorado from January 2007 through February 2011 who had CA abnormalities. A retrospective chart review was conducted to collect demographic, clinical, laboratory and echocardiogram (ECHO) data. CA abnormalities were defined as Z score ≥2.5 or presence of ectasia or aneurysms. RESULTS: A total of 210 patients with KD were identified. Fifty-seven (27.1%) of the 210 children with KD had CA abnormalities. Forty-six of the 57 (81%) children with CA abnormalities had CA abnormalities noted on their initial ECHO. Of the 46 children who had CA abnormalities detected on their initial ECHO, 37 (80%) had their ECHO on or before illness day 10. The median day of illness when abnormalities were detected on initial ECHO was day 7 (interquartile range: 5-8; range: 2-24 days). Only 25 of the 46 children (54%) were classified as complete KD, but 40 (87%) had the triad of conjunctivitis, rash and mucous membrane involvement. Thirteen (28%) had intravenous immunoglobulin-resistant disease. CONCLUSION: The majority of CA abnormalities in children with KD were identified in the initial ECHO, during the first week of illness. Earlier diagnosis and treatment is needed to impact the incidence of CA abnormalities in children with KD. Increased clinical suspicion and earlier use of ECHO in the initial workup of children with suspected KD may lead to more rapid diagnosis and treatment. © 2012 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Dominguez, Samuel R.
United States, Aurora
University of Colorado School of Medicine
Anderson, Marsha S.
United States, Aurora
University of Colorado School of Medicine
El Adawy, Mohammed
United States, Aurora
University of Colorado School of Medicine
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Glodé, Mary P.
United States, Aurora
University of Colorado School of Medicine
Statistics
Citations: 83
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.1097/INF.0b013e318266bcf9
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study