Gastrointestinal presentation of Kawasaki disease: A red flag for severe disease?

Marianna Fabi, Elena Corinaldesi, Luca Pierantoni, Elisa Mazzoni, Chiara Landini, Barbara Bigucci, Gina Ancora, Laura Malaigia, Tetyana Bodnar, Giorgia Di Fazzio, Francesca Lami, Enrico Valletta, Cristina Cicero, Giacomo Biasucci, Lorenzo Iughetti, Federico Marchetti, Paola Sogno Valin, Sergio Amarri, Sandra Brusa, Monica Sprocati, Giuseppe Maggiore, Ada Dormi, Paolo Lanzoni, Andrea Donti and Marcello Lanari

PLOS ONE, 2018, vol. 13, issue 9, 1-10

Abstract: Background: Kawasaki disease (KD) is a febrile systemic vasculitis of unknown etiology and the main cause of acquired heart disease among children in the developed world. To date, abdominal involvement at presentation is not recognized as a risk factor for a more severe form of the disease. Objective: To evaluate whether presenting abdominal manifestations identify a group at major risk for Intravenous immunoglobulin (IVIG)-resistance and coronary lesions. Methods: Retrospective study of KD patients diagnosed between 2000 and 2015 in 13 pediatric units in Italy. Patients were divided into 2 groups according to the presence or absence of abdominal manifestations at onset. We compared their demographic and clinical data, IVIG-responsiveness, coronary ectasia/aneurysms, laboratory findings from the acute and subacute phases. Results: 302 patients (181 boys) were enrolled: 106 patients with, and 196 patients without presenting abdominal features. Seasonality was different between the groups (p = 0.034). Patients with abdominal manifestations were younger (p = 0.006) and more frequently underwent delayed treatment (p = 0.014). In the acute phase, patients with abdominal presentation had higher platelet counts (PLT) (p = 0.042) and lower albuminemia (p = 0.009), while, in the subacute phase, they had higher white blood cell counts (WBC) and PLT (p = 0.002 and p

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0202658

DOI: 10.1371/journal.pone.0202658

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