The Risk Factors of Carditis in Children with Kawasaki Disease

Seo, Jang Won; Ryu, Myong Sun; Kil, Hong Ryang

Abstract

PURPOSE
The most common complication of Kawasaki disease(KD) is the development of coronary artery aneurysm. Other cardiac complication include myocarditis, pericarditis, mitral or aortic insufficiency, congestive failure, and arrhythmia. These non- coronary cardiac problems have important role on clinical course in acute phase of KD. Extensive researches have been performed about the pathogenesis, natural course and treatment of coronary artery lesion. But the studies about non-coronary cardiac complication have been limited, so we aimed to study the manifestation, incidence, and clinical predictor of carditis.
METHODS
The retrospective studies was performed to the 48 KD patients diagnosed in Chungnam National University Hospital from May 1998 to September 2004. The patients were divided into two groups. Patients with carditis(11 patients) and without carditis(37 patients) before receiving the IVGG infusion were analyzed.
RESULTS
There were no differences in age and sex between two groups. Patients with long duration of fever and high Harada score had the significant increase in the incidence of carditis before the initial IVGG infusion. No significant differences were not shown between the two groups in terms of WBC count, hemoglobin, hematocrit, platelet count, total protein, AST/ALT, LDH, CPK, troponin I, total cholesterol, and triglyceride before the initiL IVGG infusion. The incidence of carditis was high in patient with high CRP, low albumin, and high cholesterol and triglyceride.
CONCLUSION
The possibility of significant carditis should be considered before the infusion of high dose IVIG, which may worse the caridac dysfunction. Some predictors of significant carditis such as long duration of fever, high Harada score, high levels of CRP, and low levels of albumin can be suggested.