Gastrointestinal presentation of kawasaki disease: A red flag for severe disease?
| Autor: | Marianna Fabi, Monica Sprocati, Giorgia Di Fazzio, Federico Marchetti, Paolo Lanzoni, Barbara Bigucci, Paola Sogno Valin, Luca Pierantoni, Andrea Donti, Sergio Amarri, Laura Malaigia, Marcello Lanari, Gina Ancora, Ada Dormi, Giacomo Biasucci, Lorenzo Iughetti, S. Brusa, Enrico Valletta, Giuseppe Maggiore, Cristina Cicero, Elena Corinaldesi, Tetyana Bodnar, Elisa Mazzoni, Francesca Lami, Chiara Landini |
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| Přispěvatelé: | Fabi, Marianna, Corinaldesi, Elena, Pierantoni, Luca, Mazzoni, Elisa, Landini, Chiara, Bigucci, Barbara, Ancora, Gina, Malaigia, Laura, Bodnar, Tetyana, Fazzio, Giorgia Di, Lami, Francesca, Valletta, Enrico, Cicero, Cristina, Biasucci, Giacomo, Iughetti, Lorenzo, Marchetti, Federico, Valin, Paola Sogno, Amarri, Sergio, Brusa, Sandra, Sprocati, Monica, Maggiore, Giuseppe, Dormi, Ada, Lanzoni, Paolo, Donti, Andrea, Lanari, Marcello |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Genetics and Molecular Biology (all) Abdominal pain Heart disease Drug Resistance lcsh:Medicine Gastroenterology Biochemistry Cohort Studies 0302 clinical medicine Risk Factors Biochemistry Genetics and Molecular Biology (all) Agricultural and Biological Sciences (all) Medicine 030212 general & internal medicine lcsh:Science Child Multidisciplinary Age Factors Coronary Aneurysm Immunoglobulins Intravenous medicine.anatomical_structure Italy Child Preschool Female medicine.symptom Systemic vasculitis Dilatation Pathologic medicine.medical_specialty Vomiting Socio-culturale Mucocutaneous Lymph Node Syndrome 03 medical and health sciences 030225 pediatrics Internal medicine Humans Risk factor Serum Albumin Retrospective Studies business.industry Platelet Count lcsh:R Infant Retrospective cohort study medicine.disease Abdominal Pain Coronary arteries Etiology lcsh:Q Kawasaki disease business |
| Zdroj: | PLoS ONE, Vol 13, Iss 9, p e0202658 (2018) |
| Popis: | Background Kawasaki disease (KD) is a febrile systemic vasculitis of unknown etiology and the main cause of acquired heart disease among children in the developed world. To date, abdominal involvement at presentation is not recognized as a risk factor for a more severe form of the disease. Objective To evaluate whether presenting abdominal manifestations identify a group at major risk for Intravenous immunoglobulin (IVIG)-resistance and coronary lesions. Methods Retrospective study of KD patients diagnosed between 2000 and 2015 in 13 pediatric units in Italy. Patients were divided into 2 groups according to the presence or absence of abdominal manifestations at onset. We compared their demographic and clinical data, IVIG-responsiveness, coronary ectasia/aneurysms, laboratory findings from the acute and subacute phases. Results 302 patients (181 boys) were enrolled: 106 patients with, and 196 patients without presenting abdominal features. Seasonality was different between the groups (p = 0.034). Patients with abdominal manifestations were younger (p = 0.006) and more frequently underwent delayed treatment (p = 0.014). In the acute phase, patients with abdominal presentation had higher platelet counts (PLT) (p = 0.042) and lower albuminemia (p = 0.009), while, in the subacute phase, they had higher white blood cell counts (WBC) and PLT (p = 0.002 and p < 0.005, respectively) and lower red blood cell counts (RBC) and hemoglobin (Hb) (p = 0.031 and p 0.009). Moreover, the above mentioned group was more likely to be IVIG-resistant (p < 0.005) and have coronary aneurysms (p = 0.007). In the multivariate analysis, presenting abdominal manifestations, age younger than 6 months, IVIG- resistance, delayed treatment and albumin concentration in the acute phase were independent risk factors for coronary aneurysms (respectively p |
| Databáze: | OpenAIRE |
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