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Diagnostic characteristics of supplemental laboratory criteria for incomplete Kawasaki disease in children with complete Kawasaki disease.

Jun HO, Yu JJ, Kang SY, Seo CD, Baek JS, Kim YH, Ko JK - Korean J Pediatr (2015)

Bottom Line: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease.In 106 patients, laboratory testing was performed more than twice.The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: In 2004, the American Heart Association (AHA) had published an algorithm for the diagnosis of incomplete Kawasaki disease (KD). The aim of the present study was to investigate characteristics of supplemental laboratory criteria in this algorithm.

Methods: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease. Laboratory data were obtained before the initial IVIG administration and up to 10 days after fever onset. In 106 patients, laboratory testing was performed more than twice.

Results: The AHA supplemental laboratory criteria were fulfilled in 90 patients (25.4%), and the frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) was a significant predictor of it. The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001).

Conclusion: Repeated laboratory testing increased the rate of fulfillment of the AHA supplemental laboratory criteria in children with KD.

No MeSH data available.


Related in: MedlinePlus

Percentage of patients fulfilling American Heart Association (AHA) supplemental laboratory criteria for the diagnosis of incomplete Kawasaki disease. Comparison between the results of patients who underwent a single laboratory test and those of patients who underwent multiple tests.
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Figure 1: Percentage of patients fulfilling American Heart Association (AHA) supplemental laboratory criteria for the diagnosis of incomplete Kawasaki disease. Comparison between the results of patients who underwent a single laboratory test and those of patients who underwent multiple tests.

Mentions: The patients' clinical and laboratory data are shown in Tables 1, 2. The AHA laboratory criteria were fulfilled in 90 patients (25.4 %). Clinical variables found to be associated with the fulfillment of the AHA supplemental laboratory criteria were as follows: the day of initial IVIG (P=0.029) and the frequency of laboratory examination (P<0.001). The frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) also remained as a significant predictor for the fulfillment of the AHA supplemental laboratory criteria in multivariate analysis. One hundred six patients who underwent multiple laboratory testing fulfilled the AHA supplemental laboratory criteria more often than 249 patients who underwent single testing (43.0 % vs. 18.1%, P<0.001) (Fig. 1).


Diagnostic characteristics of supplemental laboratory criteria for incomplete Kawasaki disease in children with complete Kawasaki disease.

Jun HO, Yu JJ, Kang SY, Seo CD, Baek JS, Kim YH, Ko JK - Korean J Pediatr (2015)

Percentage of patients fulfilling American Heart Association (AHA) supplemental laboratory criteria for the diagnosis of incomplete Kawasaki disease. Comparison between the results of patients who underwent a single laboratory test and those of patients who underwent multiple tests.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644764&req=5

Figure 1: Percentage of patients fulfilling American Heart Association (AHA) supplemental laboratory criteria for the diagnosis of incomplete Kawasaki disease. Comparison between the results of patients who underwent a single laboratory test and those of patients who underwent multiple tests.
Mentions: The patients' clinical and laboratory data are shown in Tables 1, 2. The AHA laboratory criteria were fulfilled in 90 patients (25.4 %). Clinical variables found to be associated with the fulfillment of the AHA supplemental laboratory criteria were as follows: the day of initial IVIG (P=0.029) and the frequency of laboratory examination (P<0.001). The frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) also remained as a significant predictor for the fulfillment of the AHA supplemental laboratory criteria in multivariate analysis. One hundred six patients who underwent multiple laboratory testing fulfilled the AHA supplemental laboratory criteria more often than 249 patients who underwent single testing (43.0 % vs. 18.1%, P<0.001) (Fig. 1).

Bottom Line: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease.In 106 patients, laboratory testing was performed more than twice.The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: In 2004, the American Heart Association (AHA) had published an algorithm for the diagnosis of incomplete Kawasaki disease (KD). The aim of the present study was to investigate characteristics of supplemental laboratory criteria in this algorithm.

Methods: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease. Laboratory data were obtained before the initial IVIG administration and up to 10 days after fever onset. In 106 patients, laboratory testing was performed more than twice.

Results: The AHA supplemental laboratory criteria were fulfilled in 90 patients (25.4%), and the frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) was a significant predictor of it. The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001).

Conclusion: Repeated laboratory testing increased the rate of fulfillment of the AHA supplemental laboratory criteria in children with KD.

No MeSH data available.


Related in: MedlinePlus