Korean J Pediatr.  2019 Aug;62(8):301-306. 10.3345/kjp.2018.06905.

Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease

Affiliations
  • 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. lucyeun@yuhs.ac

Abstract

PURPOSE
Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA.
METHODS
This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models.
RESULTS
Serum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851-0.963), 0.729 (95% CI, 0.648-0.810), 0.711 (95% CI, 0.629-0.793), 0.638 (95% CI, 0.545-0.731), and 0.563 (95% CI, 0.489-0.636), respectively.
CONCLUSION
Indicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.

Keyword

Iron deficiency anemia; Kawasaki disease; Coronary artery abnormalities

MeSH Terms

Anemia
Anemia, Iron-Deficiency*
Coronary Vessels*
Early Intervention (Education)
Ferritins
Humans
Iron*
Logistic Models
Micronutrients
Mucocutaneous Lymph Node Syndrome*
Odds Ratio
Retrospective Studies
Ferritins
Iron
Micronutrients
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