Clinical observation of noncoronary cardiac abnormalities in Chinese children with Kawasaki disease.

Abstract

BACKGROUND:

Kawasaki disease (KD) is an acute, self-limited vasculitis. Coronary artery aneurysm (CAA) serves as a major contributor to the long-term prognosis of KD. In addition, acute KD usually also leads to several kinds of noncoronary cardiac abnormalities (NCA) involving the pericardium, myocardium and endocardium.

MATERIALS AND METHODS:

A total of 142 Chinese children with KD were recruited from July 2015 to April 2018. Blood samples were collected at 24 hours pre-intravenous immunoglobulin (IVIG) therapy. Several inflammatory mediators and biomarkers for acute myocardial infarction were detected. Echocardiography and electrocardiography (ECG) were performed.

RESULTS:

Plasma white blood cell counts (WBC) were significantly increased in patients with IVIG-nonresponsive KD when compared with their IVIG-responsive counterparts. A total of 106 children (74.65%) suffered from NCA, including 8 patients (5.63%) with pericardial effusion, 23 patients (16.20%) with acute myocarditis, 101 patients (71.13%) with valvular regurgitation and 8 patients (5.63%) with abnormal ECG. No significant differences were observed in the distribution of clinical classification and the response to IVIG therapy regardless of NCA exhibited or not.

CONCLUSIONS:

Noncoronary cardiac abnormalities is almost universal in acute KD and mainly manifests as valvular regurgitation. However, it has no influence on clinical classification and the response to IVIG therapy.

• Authors: Fei Fei Liu, Hui Hui Liu, Zhen Qiu, Jing Jing Wang, Sama Samadli, Yue Wu, Yang Fang Wu, Yao Xu, Huang Huang Luo, Wei Xia Chen, Dong Dong Zhang, Peng Hu
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 50 Issue 4 Pg. e13210 (Apr 2020) ISSN: 1365-2362 [Electronic] England
• PMID: 32061097 (Publication Type: Journal Article)
• Copyright: © 2020 Stichting European Society for Clinical Investigation Journal Foundation.

Chemical References

• Immunoglobulins, Intravenous
• Immunologic Factors
• Troponin T
• Creatine Kinase, MB Form

Topics

• Adolescent
• Aortic Valve Insufficiency (epidemiology, etiology)
• Child
• Child, Preschool
• China (epidemiology)
• Coronary Aneurysm (epidemiology, etiology)
• Creatine Kinase, MB Form (blood)
• Echocardiography
• Electrocardiography
• Female
• Heart Valve Diseases (epidemiology, etiology)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Infant
• Male
• Mitral Valve Insufficiency (epidemiology, etiology)
• Mucocutaneous Lymph Node Syndrome (blood, complications, physiopathology, therapy)
• Myocarditis (epidemiology, etiology)
• Pericardial Effusion (epidemiology, etiology)
• Tricuspid Valve Insufficiency (epidemiology, etiology)
• Troponin T (blood)