Korean J Pediatr.  2017 Feb;60(2):38-44. 10.3345/kjp.2017.60.2.38.

Relationship between serum sodium level and coronary artery abnormality in Kawasaki disease

• Park S
• Eun LY
• Kim JH

• KMID: 2371376
• DOI: http://doi.org/10.3345/kjp.2017.60.2.38

Abstract

PURPOSE
Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in KD.
METHODS
We conducted a retrospective review of medical records for 104 patients with KD from January 2015 to December 2015. Patients with serum Na levels of <135 mEq/L at the time of initial diagnosis were assigned to the hyponatremia group. Laboratory findings and echocardiographic data were analyzed for various aspects.
RESULTS
Among the 104 patients with KD, 91 were included in the study, of whom 48 (52.7%) had hyponatremia. The degree of fever, white blood cell count, percentage of neutrophils, percentage of lymphocytes, total bilirubin level, brain natriuretic peptide level, erythrocyte sedimentation rate, and C-reactive protein level were higher in the patients with hyponatremia. They also demonstrated a trend of larger coronary artery diameters based on Z scores.
CONCLUSION
The severity of vascular inflammation in acute KD with hyponatremia might worsen the prognosis of coronary vasculature. Although no statistically significant correlation was found between the initial serum sodium levels and coronary arteriopathy in the patients with KD in this study, a long-term follow-up study with a larger number of enrolled patients should be designed in the future to elucidate the relationship between serum sodium level and coronary arteriopathy in patients with KD.

Keyword

Sodium; Coronary arteries; KD

MeSH Terms

Bilirubin
Blood Sedimentation
C-Reactive Protein
Child
Coronary Vessels*
Diagnosis
Echocardiography
Fever
Follow-Up Studies
Humans
Hyponatremia
Inflammation
Leukocyte Count
Lymphocytes
Medical Records
Mucocutaneous Lymph Node Syndrome*
Natriuretic Peptide, Brain
Neutrophils
Prognosis
Retrospective Studies
Sodium*
Vascular System Injuries
Vasculitis
Bilirubin
C-Reactive Protein
Natriuretic Peptide, Brain
Sodium