Coronary risk factors in acute Kawasaki disease: Correlation of serum immunoglobulin levels with coronary complications |
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Authors: | Yoichi Sawaji Noriyuki Haneda Seiji Yamaguchi Yasuhisa Kajino Kenji Kishida Shiro Seto Nakao Konishi Kenji Waki Kiyoshi Baba Kokichi Arisawa Tetsuro Kamiya Chuzo Mori |
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Institution: | Department of Pediatrics, Shimane Medical University, Izumo;Department of Pediatrics. Masuda Red-Cross Hospital, Masuda;Department of Pediatrics, Kokura Memorial Hospital, Kitakyusyu;Department of Pediatrics, Kishiwada City Hospital, Kishiwada;department of Pediatric Cardiology, Kurashiki Central Hospital, Kurashiki;Department of Preventive Medicine and Health Promotion, Nagasaki University School of Medicine, Nagasaki;Department of Pediatrics, National Cardiovascular Center, Osaka;Department of Clinical Psychology, Kyoto-Bunkyo Junior College, Uji Kyoto, Japan |
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Abstract: | Abstract Background To determine the usefulness of the IgG z-score (age and sex-standardized serum IgG level) before intravenous gamma globulin therapy (1VGG) in predicting the occurrence or severity of coronary complications in Kawasaki disease (KD). Methods A case-control study of clinical and laboratory findings with 88 children in the early stage of acute KD who received IVGG (100 or 200 mg/kg for2–5 days) therapy. Of these, 20 cases had persistent coronary arterial lesions (small aneurysm, moderate aneurysm or large aneurysm persisting more than 1 month). The controls comprised 68 children with no coronary aneurysms or transient small aneurysm only observed within 1 month after the onset of KD. The association between serum levels of immunoglobulin G (IgG), IgM, IgA as well as other coronary risk factors previously reported and the occurrence of the coronary arterial lesions was evaluated using logistic regression analysis. Results: After adjustment for age, gender, total IVGG dose before the 9th illness day and other traditional coronary risk factors, the odds ratio for the persistent coronary aneurysm associated with lower serum IgG r-score (<-0.7485 v.v & -0.7485). was 30.3 (95% confidence interval, 3.8–243.2). Furthermore, the serum IgG z-score was inversely correlated with the severity of the coronary arterial lesion. Conclusions: The IgG z-score before IVGG therapy in the early stage of KD provides useful information on the risk factors for persistent coronary aneurysm and is a novel, additional indicator for therapy to prevent the coronary complications in acute KD. |
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Keywords: | coronary aneurysm IgG z-score intravenous gamma globulin Kawasaki disease serum IgG |
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