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High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease

PURPOSE: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin...

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Autores principales: Min, Dong Eun, Kim, Do Hee, Han, Mi Young, Cha, Sung Ho, Yoon, Kyung Lim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Pediatric Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584233/
https://www.ncbi.nlm.nih.gov/pubmed/30404429
http://dx.doi.org/10.3345/kjp.2018.06989
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author Min, Dong Eun
Kim, Do Hee
Han, Mi Young
Cha, Sung Ho
Yoon, Kyung Lim
author_facet Min, Dong Eun
Kim, Do Hee
Han, Mi Young
Cha, Sung Ho
Yoon, Kyung Lim
author_sort Min, Dong Eun
collection PubMed
description PURPOSE: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin O (ASO) titer. Therefore, we hypothesized that KD patients diagnosed with concurrent streptococcal infection have poor prognoses, with respect to treatment response and development of coronary artery lesions. METHODS: A retrospective review was performed in 723 patients with KD who were admitted to 2 major hospitals between June 2010 and September 2017. RESULTS: Among 723 patients with KD, 11 initially showed an elevated ASO titer (>320 IU/mL) or elevated follow-up ASO titer after treatment. Of these patients, 5 showed no response to the first intravenous immunoglobulin treatment, 3 had abnormalities of the coronary arteries. This is a significantly higher proportion of patients with a high ASO titer (n=3, 27.3%) than those with a normal ASO titer (n=53 [7.4%], P=0.047). A severe clinical course was seen in 81.8% of patients in the high ASO group versus 14.5% of patients in the normal ASO group. CONCLUSION: It is not certain whether acute streptococcal infection may cause KD, but this study revealed that KD with high ASO titers showed higher rates of severe clinical course. It may be helpful to analyze concurrent streptococcal infection in patients with a severe clinical course.
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spelling pubmed-65842332019-06-25 High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease Min, Dong Eun Kim, Do Hee Han, Mi Young Cha, Sung Ho Yoon, Kyung Lim Korean J Pediatr Original Article PURPOSE: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin O (ASO) titer. Therefore, we hypothesized that KD patients diagnosed with concurrent streptococcal infection have poor prognoses, with respect to treatment response and development of coronary artery lesions. METHODS: A retrospective review was performed in 723 patients with KD who were admitted to 2 major hospitals between June 2010 and September 2017. RESULTS: Among 723 patients with KD, 11 initially showed an elevated ASO titer (>320 IU/mL) or elevated follow-up ASO titer after treatment. Of these patients, 5 showed no response to the first intravenous immunoglobulin treatment, 3 had abnormalities of the coronary arteries. This is a significantly higher proportion of patients with a high ASO titer (n=3, 27.3%) than those with a normal ASO titer (n=53 [7.4%], P=0.047). A severe clinical course was seen in 81.8% of patients in the high ASO group versus 14.5% of patients in the normal ASO group. CONCLUSION: It is not certain whether acute streptococcal infection may cause KD, but this study revealed that KD with high ASO titers showed higher rates of severe clinical course. It may be helpful to analyze concurrent streptococcal infection in patients with a severe clinical course. Korean Pediatric Society 2019-06 2018-11-07 /pmc/articles/PMC6584233/ /pubmed/30404429 http://dx.doi.org/10.3345/kjp.2018.06989 Text en Copyright © 2019 by The Korean Pediatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Min, Dong Eun
Kim, Do Hee
Han, Mi Young
Cha, Sung Ho
Yoon, Kyung Lim
High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title_full High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title_fullStr High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title_full_unstemmed High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title_short High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
title_sort high antistreptolysin o titer is associated with coronary artery lesions in patients with kawasaki disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584233/
https://www.ncbi.nlm.nih.gov/pubmed/30404429
http://dx.doi.org/10.3345/kjp.2018.06989
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