Risk Factors of Coronary Involvement in Kawasaki Disease in Recent Outbreak in South Iran, Shiraz.

Abstract

Background: During the past year, Kawasaki disease (KD) had an outbreak with a high inci-dence of coronary involvement in Shiraz, Iran. This study focuses on risk factors and their correlation with aneurysm formation. Methods: All patients who were admitted with the diagnosis of KD in the pediatric units of Shiraz, Iran between 2009 and 2010 were included in this study. Data analysis was performed on demographic as well as clinical features, laboratory data, echocardiography, and electrocardiogram as well as treatment details. Results: The population under study included 45 patients, 25 males (55.6%) and 20 females (44.4%), with the mean age of 3.52 ± 2.77 years. Aneurysm was seen in 10 cases (22.2%) with the male to female ratio of 9:1. The most important risk factor of aneurysm formation was the male gender with the odds ratio of 10.6. Age more than 8 years was a very specific but non-sensitive predictor of aneurysm formation (sensitivity: 40% and specificity: 100%). Platelet counts more than 424Aƒâ€”103 was the most sensitive predictor of aneurysm formation (sensitivity: 90% and specificity: 57.1%). Fever duration more than 10 days had the sensitivity of 60% and the specificity of 88.6% for developing coronary aneurysm. No significant difference was seen in other clinical symptoms and laboratory data including complete blood count, liver function test, renal function test, electrolyte, and ECG data. Conclusion: Male gender, older age, prolong fever before treatment, and higher platelet counts were the risk factors of coronary aneurysm in KD. More education for early diagnosis of Kawa-saki disease in older patients is highly recommended.