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Corticosteroid Therapy Might be Associated with the Development of Coronary Aneurysm in Children with Kawasaki Disease

Chun-Na Zhao Zhong-Dong Du Ling-Ling Gao

Chinese medical journal, 2016, Vol.129 (8), p.922-928 [Peer Reviewed Journal]

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Title:
Corticosteroid Therapy Might be Associated with the Development of Coronary Aneurysm in Children with Kawasaki Disease
Author: Chun-Na Zhao Zhong-Dong Du Ling-Ling Gao
Subjects: 激素治疗 ; 糖皮质激素 ; 动脉瘤 ; Logistic回归分析 ; 危险因素 ; logistic回归模型 ; Adrenal Cortex Hormones - adverse effects ; Mucocutaneous Lymph Node Syndrome - drug therapy ; Humans ; Adolescent ; Child, Preschool ; Female ; Infant ; Logistic Models ; Male ; Coronary Aneurysm - chemically induced ; Retrospective Studies ; Aneurysms ; Kawasaki disease ; Corticosteroids ; Risk factors ; Care and treatment ; Dosage and administration ; Research ; Pediatrics ; Immunoglobulins ; Laboratories ; Cardiovascular disease ; Fever ; Children & youth ; Hospitals ; Education ; Coronary vessels ; Standard deviation ; Health risk assessment ; Cardiology ; Veins & arteries ; Index Medicus ; Corticosteroid Therapy ; Coronary Artery Lesions ; Kawasaki Disease ; Original ; Coronary Artery Aneurysms ; Risk Factors ; Coronary Artery Aneurysms; Coronary Artery Lesions; Corticosteroid Therapy; Kawasaki Disease; Risk Factors
Is Part Of: Chinese medical journal, 2016, Vol.129 (8), p.922-928
Description: Background：Coronary artery lesions （CALs） are known to be the main complication in children with Kawasaki disease （KD）.Instead of intravenous immunoglobulin （IVIG）,corticosteroid therapy has been accepted to be used for children with KD who are unresponsive to IVIG.This study aimed to evaluate risk factors for CALs in children with KD.Methods：We retrospectively reviewed the clinical records of 2331 children with KD from January 2005 to December 2014.To identify the independent risk factors for CALs,multivariable logistic regression models were constructed using significant variables identified from univariate logistic regression analysis.Results：The incidence of CALs was 36.0% （840 of 2331）,including 625 （26.8%） coronary artery dilations and 215 （9.2%） coronary artery aneurysms （CAAs）.Multivariable logistic regression analysis identified that male,incomplete KD,longer fever duration,and C-reactive protein （CRP）〉 100 mg/L were independent risk factors for coronary artery dilatations.On the other hand,male,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,corticosteroid therapy,sodium ≤133 mmol/L,and albumin 〈35 g/L were the independent risk factors for CAAs.In addition,corticosteroid therapy,prolonged days of illness at the initial treatment,and albumin 〈35 g/L were the independent risk factors for giant CAAs.Conclusions：CALs might be associated with male sex,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,albumin 〈35 g/L,sodium ≤ 133 mmol/L,CRP 〉 100 mg/L,and corticosteroid therapy.Corticosteroid therapy was an independent risk factor for CAAs and giant CAAs.Thus,corticosteroids should be used with caution in the treatment of KD with the risk for CALs.
Publisher: China: Wolters Kluwer - Medknow Publications
Language: English
Identifier: ISSN: 0366-6999
EISSN: 2542-5641
DOI: 10.4103/0366-6999.179801
PMID: 27064036

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Corticosteroid Therapy Might be Associated with the Development of Coronary Aneurysm in Children with Kawasaki Disease

Chun-Na Zhao Zhong-Dong Du Ling-Ling Gao

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