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Giant coronary artery aneurysms complicating Kawasaki disease in Mexican children

Published online by Cambridge University Press:  29 August 2017

Luis M. Garrido-García ,
Edna Morán-Villaseñor ,
Marco A. Yamazaki-Nakashimada ,
Patricia Cravioto  and
Fernando Galván
Luis M. Garrido-García*
Affiliation:
Cardiology Department, National Institute of Paediatrics, Mexico City, Mexico
Edna Morán-Villaseñor
Affiliation:
Dermatology Department, National Institute of Paediatrics, Mexico City, Mexico
Marco A. Yamazaki-Nakashimada
Affiliation:
Immunology Department, National Institute of Paediatrics, Mexico City, Mexico
Patricia Cravioto
Affiliation:
Teaching Department, National Institute of Paediatrics, Mexico City, Mexico
Fernando Galván
Affiliation:
Teaching Department, National Institute of Paediatrics, Mexico City, Mexico
*
Correspondence to: L. M. Garrido-García, MD, MSc, Cardiology Department, National Institute of Paediatrics, Av. Insurgentes Sur 3700-C, Colonia Insurgentes Cuicuilco, Mexico City, 04530, Mexico. Tel: +52 551 353 7829; Fax: + 52 55 10840900; E-mail: luismartin_garr@hotmail.com
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Abstract

Background

One of the most important complications of Kawasaki disease is the development of giant coronary aneurysms. Risk factors for their development are still not clear.

Methods

A retrospective analysis was conducted at the National Institute of Paediatrics in Mexico City, Mexico. It included all patients with a diagnosis of acute Kawasaki disease between August, 1995 and August, 2015. Clinical and laboratory findings, as well as echocardiographic measurements, were recorded. Patients with giant coronary aneurysms (z-score⩾10) were compared with the rest of the patients. A value of p<0.05 was considered statistically significant. Odds ratios and their 95% confidence intervals were calculated to define risk factors.

Results

During the study period, 416 patients were diagnosed with Kawasaki disease. Of them, 34 developed giant coronary aneurysms during the acute stage of the disease. In the multivariate analysis, patients younger than 1 year, those with a higher duration of illness at the time of diagnosis, and those who received additional intravenous immunoglobulin showed a significantly higher frequency of giant coronary aneurysms.

Conclusions

One of the main factors associated with the development of giant coronary aneurysms was the delay in the diagnosis of Kawasaki disease. This finding highlights the importance of maintaining a high suspicion of the disease, which would enable an early diagnosis and prompt treatment and decrease the risk for developing giant coronary aneurysms.

Keywords

Kawasaki diseasegiant coronary aneurysmsrisk factors
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 3 , March 2018 , pp. 386 - 390
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Copyright
© Cambridge University Press 2017 

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