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Correlation of Coronary Artery Abnormalities with Fever Pattern in Patients with Kawasaki Disease.
Tanaka, Atsushi; Inoue, Masataka; Hoshina, Takayuki; Koga, Hiroshi.
Afiliação
  • Tanaka A; Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
  • Inoue M; Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
  • Hoshina T; Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
  • Koga H; Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan. Electronic address: sakuraliberty@yahoo.co.jp.
J Pediatr ; 236: 95-100, 2021 Sep.
Article em En | MEDLINE | ID: mdl-34019881
OBJECTIVE: To investigate the incidence of coronary artery abnormalities (CAAs) by fever pattern after intravenous immunoglobulin (IVIG) therapy in patients with Kawasaki disease. STUDY DESIGN: This retrospective cohort study included 172 patients with Kawasaki disease aged ≤12 years who underwent IVIG therapy and had no CAAs before treatment. Resistance to initial IVIG was defined as persistent fever ≥37.5 °C for ≥24 hours after therapy or the recurrence of Kawasaki disease after initial defervescence. The patients were divided into 3 groups: IVIG responders, nonresponders with persistent fever, and nonresponders with recurrent fever. CAAs were evaluated 2 or 4 weeks and 12 months after onset and were defined by a coronary artery z-score ≥2.5. RESULTS: The incidence of CAAs within 12 months after onset was significantly higher in nonresponders with persistent fever (27%) compared with the other 2 groups. On multivariate logistic regression analysis, being a nonresponder with persistent fever was an independent risk factor for having CAAs within 12 months after the onset of Kawasaki disease (OR, 6.48; P = .007). CONCLUSIONS: In patients with Kawasaki disease resistant to IVIG therapy, persistent fever, but not recurrent fever, was found to be a risk factor for the incidence of CAAs. Aggressive additional therapy may be beneficial to prevent CAA formation in patients with Kawasaki disease with persistent fever.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulinas Intravenosas / Anomalias dos Vasos Coronários / Febre / Fatores Imunológicos / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imunoglobulinas Intravenosas / Anomalias dos Vasos Coronários / Febre / Fatores Imunológicos / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão País de publicação: Estados Unidos