Korean Circ J.  2018 Apr;48(4):287-295. 10.4070/kcj.2017.0342.

Laboratory Markers in Incomplete Kawasaki Disease according to Coronary Artery Outcome

• Ha KS
• Jang GY
• Lee J
• Lee KC
• Son CS

• KMID: 2407898
• DOI: http://doi.org/10.4070/kcj.2017.0342

Abstract

BACKGROUND AND OBJECTIVES
We defined laboratory marker profiles typical of incomplete Kawasaki disease (iKD) during illness, especially with respect to the presence of a coronary artery abnormality such as coronary artery dilation or aneurysm.
METHODS
This retrospective study examined the clinical and laboratory markers of patients with iKD over time, along with those of patients with complete KD (cKD) and febrile controls.
RESULTS
Of 795 patients, 178 had iKD, 504 had cKD and 113 were febrile controls. During the transition from the acute to subacute phase, the age-adjusted hemoglobin levels and platelet counts were significantly lower and higher, respectively, in the subacute phase than in the acute phase in both iKD and cKD patients, which differed from those of febrile controls. Lower levels of acute and subacute age-adjusted hemoglobin levels in iKD patients (odds ratio [OR], 0.538 and 0.583; p=0.006 and 0.018, respectively) and higher subacute platelet counts in cKD patients (OR, 1.004; p=0.014) were correlated with the risk of coronary dilation. A higher acute neutrophil-to-lymphocyte ratio was associated with aneurysm only in cKD patients (OR, 1.059; p=0.044).
CONCLUSIONS
The iKD patients share KD-specific laboratory marker profiles in terms of complete blood cell counts and acute phase reactant levels with cKD patients. However, the factors predicting coronary dilation differ according to the phenotype; lower acute and subacute age-adjusted hemoglobin levels predict coronary dilation only in iKD patients.

Keyword

Mucocutaneous lymph node syndrome; Coronary artery disease; Biomarkers

MeSH Terms

Aneurysm
Biomarkers*
Blood Cell Count
Coronary Artery Disease
Coronary Vessels*
Humans
Mucocutaneous Lymph Node Syndrome*
Phenotype
Platelet Count
Retrospective Studies
Biomarkers

Figure

• 

  Figure 1 Laboratory profiles of IVIG -treated patients with cKD, iKD, and febrile controls. The 3 phases are defined as acute (febrile phase before IVIG), subacute (2 days after defervescence), and convalescent (4–6 weeks after defervescence). Box plots show the median values, with the 25 and 75 percentiles. Ferritin data were obtained from 121 patients with cKD, 51 with iKD, and 22 febrile controls during the acute phase, from 99 patients with cKD and 41 with iKD during the subacute phase, and from 71 patients with cKD and 33 with iKD during the convalescent phase.cKD = complete Kawasaki disease; CRP = C-reactive protein; ESR = erythrocyte sedimentation rate; iKD = incomplete Kawasaki disease; IVIG = intravenous immunoglobulin.*Indicates a p<0.05, †Indicates a p<0.001.

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