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Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease

OBJECTIVE: The aims of this study were to characterize the evolution of routine blood values within the first 10 days of illness and coronary artery outcome in infants < 8 months with Kawasaki disease (KD) and to identify risk factors for coronary artery aneurysm (CAA). METHODS: Laboratory data,...

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Autores principales: Haiyan, Ge, Jianming, Lai, Suqian, Tong, Dong, Qu, Shuang, Liu, Jin, Zhang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739637/
https://www.ncbi.nlm.nih.gov/pubmed/34996405
http://dx.doi.org/10.1186/s12887-021-03083-3
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author Haiyan, Ge
Jianming, Lai
Suqian, Tong
Dong, Qu
Shuang, Liu
Jin, Zhang
author_facet Haiyan, Ge
Jianming, Lai
Suqian, Tong
Dong, Qu
Shuang, Liu
Jin, Zhang
author_sort Haiyan, Ge
collection PubMed
description OBJECTIVE: The aims of this study were to characterize the evolution of routine blood values within the first 10 days of illness and coronary artery outcome in infants < 8 months with Kawasaki disease (KD) and to identify risk factors for coronary artery aneurysm (CAA). METHODS: Laboratory data, clinical features and coronary artery outcomes from 78 infants < 8 months old and 86 patients between 8 months and 7 years old were retrospectively analyzed. Logistic regression analysis was conducted to evaluate the potential risk factors for CAA. RESULTS: Infants < 8 months old were more likely to present with incomplete KD (37.2% vs 4.7%, P < 0.001), erythema and induration at the BCG inoculation site (24.4% vs 3.5%, P < 0.001) and CAA (47.4% vs 15.1%, P < 0.001) even with timely diagnosis and treatment with intravenous immunoglobulin (IVIG) compared with patients ≥8 months old. Clinical feature related to diagnostic criteria for KD including bilateral conjunctival injection, oral changes, unilateral cervical lymphadenopathy and extremity changes were less common in the younger group. During the acute phase, the percentage neutrophils and neutrophil to lymphocyte ratio [NLR] peaked on median illness day 3, followed by white blood cell (WBC) and CRP on median illness day 4, hemoglobin on median illness day 7 and platelet count on median illness day 9. CAA occurred on median illness day 6 and regressed on median illness day 28. Multivariate logistic regression analysis revealed that the peak percentage neutrophils (odds ratio [OR] per 0.1: 1.597, 95% confidence interval [CI]: 1.041–2.452, P = 0.032) and the peak platelet count (OR per 10 × 10(9)/L: 1.029, 95% CI: 1.004–1.055, P = 0.024) were independent risk factors for CAA. Hemoglobin on the 5th day was associated with persistent CAA at 1 year after KD onset. CONCLUSION: Factors associated with CAA include a high peak percentage neutrophils, increased peak platelet count, and reduced hemoglobin within 4–6 days during the acute phase of KD. Therefore, this population should receive primary therapy with IVIG and adjunctive anti-inflammatory medications.
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spelling pubmed-87396372022-01-07 Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease Haiyan, Ge Jianming, Lai Suqian, Tong Dong, Qu Shuang, Liu Jin, Zhang BMC Pediatr Research OBJECTIVE: The aims of this study were to characterize the evolution of routine blood values within the first 10 days of illness and coronary artery outcome in infants < 8 months with Kawasaki disease (KD) and to identify risk factors for coronary artery aneurysm (CAA). METHODS: Laboratory data, clinical features and coronary artery outcomes from 78 infants < 8 months old and 86 patients between 8 months and 7 years old were retrospectively analyzed. Logistic regression analysis was conducted to evaluate the potential risk factors for CAA. RESULTS: Infants < 8 months old were more likely to present with incomplete KD (37.2% vs 4.7%, P < 0.001), erythema and induration at the BCG inoculation site (24.4% vs 3.5%, P < 0.001) and CAA (47.4% vs 15.1%, P < 0.001) even with timely diagnosis and treatment with intravenous immunoglobulin (IVIG) compared with patients ≥8 months old. Clinical feature related to diagnostic criteria for KD including bilateral conjunctival injection, oral changes, unilateral cervical lymphadenopathy and extremity changes were less common in the younger group. During the acute phase, the percentage neutrophils and neutrophil to lymphocyte ratio [NLR] peaked on median illness day 3, followed by white blood cell (WBC) and CRP on median illness day 4, hemoglobin on median illness day 7 and platelet count on median illness day 9. CAA occurred on median illness day 6 and regressed on median illness day 28. Multivariate logistic regression analysis revealed that the peak percentage neutrophils (odds ratio [OR] per 0.1: 1.597, 95% confidence interval [CI]: 1.041–2.452, P = 0.032) and the peak platelet count (OR per 10 × 10(9)/L: 1.029, 95% CI: 1.004–1.055, P = 0.024) were independent risk factors for CAA. Hemoglobin on the 5th day was associated with persistent CAA at 1 year after KD onset. CONCLUSION: Factors associated with CAA include a high peak percentage neutrophils, increased peak platelet count, and reduced hemoglobin within 4–6 days during the acute phase of KD. Therefore, this population should receive primary therapy with IVIG and adjunctive anti-inflammatory medications. BioMed Central 2022-01-07 /pmc/articles/PMC8739637/ /pubmed/34996405 http://dx.doi.org/10.1186/s12887-021-03083-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Haiyan, Ge
Jianming, Lai
Suqian, Tong
Dong, Qu
Shuang, Liu
Jin, Zhang
Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title_full Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title_fullStr Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title_full_unstemmed Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title_short Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease
title_sort blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with kawasaki disease
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739637/
https://www.ncbi.nlm.nih.gov/pubmed/34996405
http://dx.doi.org/10.1186/s12887-021-03083-3
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