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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

Relationship between the day of laboratory testing and the frequency at which individual laboratory variables met American Heart Association (AHA) supplemental laboratory criteria. The thick dash denotes the rate of fulfillment of AHA supplemental laboratory criteria according to the day of laboratory testing. ALT, alanine aminotransferase; WBC, white blood cell.
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Figure 2: Relationship between the day of laboratory testing and the frequency at which individual laboratory variables met American Heart Association (AHA) supplemental laboratory criteria. The thick dash denotes the rate of fulfillment of AHA supplemental laboratory criteria according to the day of laboratory testing. ALT, alanine aminotransferase; WBC, white blood cell.

Mentions: The observed increase in the tendency to fulfill the AHA supplemental laboratory criteria during a sustained bout of fever was not significant (P=0.075). Both the incidence of anemia (P=0.012) and hypoalbuminemia (P<0.001) tended to increase following a bout of sustained fever; however, neither the incidence of leukocytosis (P=0.077), the increase of ALT (P=0.126) nor the urine WBC ≥10/high power field (P=0.156) showed a significant tendency (Table 3, Fig. 2).


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)

Relationship between the day of laboratory testing and the frequency at which individual laboratory variables met American Heart Association (AHA) supplemental laboratory criteria. The thick dash denotes the rate of fulfillment of AHA supplemental laboratory criteria according to the day of laboratory testing. ALT, alanine aminotransferase; WBC, white blood cell.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Relationship between the day of laboratory testing and the frequency at which individual laboratory variables met American Heart Association (AHA) supplemental laboratory criteria. The thick dash denotes the rate of fulfillment of AHA supplemental laboratory criteria according to the day of laboratory testing. ALT, alanine aminotransferase; WBC, white blood cell.
Mentions: The observed increase in the tendency to fulfill the AHA supplemental laboratory criteria during a sustained bout of fever was not significant (P=0.075). Both the incidence of anemia (P=0.012) and hypoalbuminemia (P<0.001) tended to increase following a bout of sustained fever; however, neither the incidence of leukocytosis (P=0.077), the increase of ALT (P=0.126) nor the urine WBC ≥10/high power field (P=0.156) showed a significant tendency (Table 3, Fig. 2).

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