Assessment of risk factors for Korean children with Kawasaki disease

Jae Jung Kim; Young Mi Hong; Sin Weon Yun; Myung Ki Han; Kyung Yil Lee; Min Seob Song; Hyoung Doo Lee; Dong Soo Kim; Sejung Sohn; Kee Soo Ha; Soo Jong Hong; Kwi Joo Kim; In Sook Park; Gi Young Jang; Jong Keuk Lee

doi:10.1007/s00246-011-0143-1

Assessment of risk factors for Korean children with Kawasaki disease

Jae Jung Kim, Young Mi Hong, Sin Weon Yun, Myung Ki Han, Kyung Yil Lee, Min Seob Song, Hyoung Doo Lee, Dong Soo Kim, Sejung Sohn, Kee Soo Ha, Soo Jong Hong, Kwi Joo Kim, In Sook Park, Gi Young Jang, Jong Keuk Lee

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51 Citations (Scopus)

Abstract

Kawasaki disease (KD) is the most common cause of acquired heart disease in children. Intravenous immunoglobulin (IVIG) is the standard therapy for KD, but more than 10% ofKDpatients do not respond to IVIG and are at high risk for the development of coronary artery lesions (CALs). To identify clinical and genetic risk factors associated with CAL development and IVIG nonresponsiveness, this study analyzed the clinical data for 478 Korean KD patients. Multivariate logistic regression analysis showed that incomplete KD, IVIG nonresponse, fever duration of 7 days or longer, and the CC/ACgenotypes of the rs7604693 single nucleotide polymorphism (SNP) in the PELI1 gene were significantly associated with the development of CALs, with odds ratios (ORs) ranging from 2.06 to 3.04. The risk of CAL formation was synergistically increased by the addition of individual risk factors, particularly the genetic variant in the PELI1 gene. Multivariate analysis also showed that a serum albumin level of 3.6 g/dl or lower was significantly associated with nonresponsiveness to IVIG [OR, 2.76; 95% confidence interval (CI), 1.34-5.68; P = 0.006]. Conclusively, incomplete KD, IVIG nonresponsiveness, long febrile days, and the rs7604693 genetic variant in the PELI1 gene are major risk factors for the development of CALs, whereas low serumalbumin concentration is an independent risk factor for IVIG nonresponsiveness.

Original language	English
Pages (from-to)	513-520
Number of pages	8
Journal	Pediatric Cardiology
Volume	33
Issue number	4
DOIs	https://doi.org/10.1007/s00246-011-0143-1
Publication status	Published - 2012 Apr
Externally published	Yes

Bibliographical note

Funding Information:
We thank all the patients with KD and their families for participating in this study. We also thank Dr. Kyu-Young Song and Dr. Eul-Joo Seo for critical review of the manuscript. This work was supported by a grant (A010384) from the Ministry of Health & Welfare of the Republic of Korea and a grant (no. 2011-419) from the Asan Institute for Life Sciences, Seoul, Korea. Jae-Jung Kim was supported by a National Research Foundation of Korea Grant funded by the Korean Government (Ministry of Education, Science and Technology; NRF-2011-355-C00109).

Keywords

Coronary artery lesions
Intravenous immunoglobulin
Kawasaki disease
Korean
PELI1 gene

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Cardiology and Cardiovascular Medicine

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10.1007/s00246-011-0143-1

Cite this

@article{2e509ff75cc2494d8c9bd506c75902f0,

title = "Assessment of risk factors for Korean children with Kawasaki disease",

abstract = "Kawasaki disease (KD) is the most common cause of acquired heart disease in children. Intravenous immunoglobulin (IVIG) is the standard therapy for KD, but more than 10% ofKDpatients do not respond to IVIG and are at high risk for the development of coronary artery lesions (CALs). To identify clinical and genetic risk factors associated with CAL development and IVIG nonresponsiveness, this study analyzed the clinical data for 478 Korean KD patients. Multivariate logistic regression analysis showed that incomplete KD, IVIG nonresponse, fever duration of 7 days or longer, and the CC/ACgenotypes of the rs7604693 single nucleotide polymorphism (SNP) in the PELI1 gene were significantly associated with the development of CALs, with odds ratios (ORs) ranging from 2.06 to 3.04. The risk of CAL formation was synergistically increased by the addition of individual risk factors, particularly the genetic variant in the PELI1 gene. Multivariate analysis also showed that a serum albumin level of 3.6 g/dl or lower was significantly associated with nonresponsiveness to IVIG [OR, 2.76; 95% confidence interval (CI), 1.34-5.68; P = 0.006]. Conclusively, incomplete KD, IVIG nonresponsiveness, long febrile days, and the rs7604693 genetic variant in the PELI1 gene are major risk factors for the development of CALs, whereas low serumalbumin concentration is an independent risk factor for IVIG nonresponsiveness.",

keywords = "Coronary artery lesions, Intravenous immunoglobulin, Kawasaki disease, Korean, PELI1 gene",

author = "Kim, {Jae Jung} and Hong, {Young Mi} and Yun, {Sin Weon} and Han, {Myung Ki} and Lee, {Kyung Yil} and Song, {Min Seob} and Lee, {Hyoung Doo} and Kim, {Dong Soo} and Sejung Sohn and Ha, {Kee Soo} and Hong, {Soo Jong} and Kim, {Kwi Joo} and Park, {In Sook} and Jang, {Gi Young} and Lee, {Jong Keuk}",

note = "Funding Information: We thank all the patients with KD and their families for participating in this study. We also thank Dr. Kyu-Young Song and Dr. Eul-Joo Seo for critical review of the manuscript. This work was supported by a grant (A010384) from the Ministry of Health & Welfare of the Republic of Korea and a grant (no. 2011-419) from the Asan Institute for Life Sciences, Seoul, Korea. Jae-Jung Kim was supported by a National Research Foundation of Korea Grant funded by the Korean Government (Ministry of Education, Science and Technology; NRF-2011-355-C00109).",

year = "2012",

month = apr,

doi = "10.1007/s00246-011-0143-1",

language = "English",

volume = "33",

pages = "513--520",

journal = "Pediatric Cardiology",

issn = "0172-0643",

publisher = "Springer New York",

number = "4",

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TY - JOUR

T1 - Assessment of risk factors for Korean children with Kawasaki disease

AU - Kim, Jae Jung

AU - Hong, Young Mi

AU - Yun, Sin Weon

AU - Han, Myung Ki

AU - Lee, Kyung Yil

AU - Song, Min Seob

AU - Lee, Hyoung Doo

AU - Kim, Dong Soo

AU - Sohn, Sejung

AU - Ha, Kee Soo

AU - Hong, Soo Jong

AU - Kim, Kwi Joo

AU - Park, In Sook

AU - Jang, Gi Young

AU - Lee, Jong Keuk

N1 - Funding Information: We thank all the patients with KD and their families for participating in this study. We also thank Dr. Kyu-Young Song and Dr. Eul-Joo Seo for critical review of the manuscript. This work was supported by a grant (A010384) from the Ministry of Health & Welfare of the Republic of Korea and a grant (no. 2011-419) from the Asan Institute for Life Sciences, Seoul, Korea. Jae-Jung Kim was supported by a National Research Foundation of Korea Grant funded by the Korean Government (Ministry of Education, Science and Technology; NRF-2011-355-C00109).

PY - 2012/4

Y1 - 2012/4

N2 - Kawasaki disease (KD) is the most common cause of acquired heart disease in children. Intravenous immunoglobulin (IVIG) is the standard therapy for KD, but more than 10% ofKDpatients do not respond to IVIG and are at high risk for the development of coronary artery lesions (CALs). To identify clinical and genetic risk factors associated with CAL development and IVIG nonresponsiveness, this study analyzed the clinical data for 478 Korean KD patients. Multivariate logistic regression analysis showed that incomplete KD, IVIG nonresponse, fever duration of 7 days or longer, and the CC/ACgenotypes of the rs7604693 single nucleotide polymorphism (SNP) in the PELI1 gene were significantly associated with the development of CALs, with odds ratios (ORs) ranging from 2.06 to 3.04. The risk of CAL formation was synergistically increased by the addition of individual risk factors, particularly the genetic variant in the PELI1 gene. Multivariate analysis also showed that a serum albumin level of 3.6 g/dl or lower was significantly associated with nonresponsiveness to IVIG [OR, 2.76; 95% confidence interval (CI), 1.34-5.68; P = 0.006]. Conclusively, incomplete KD, IVIG nonresponsiveness, long febrile days, and the rs7604693 genetic variant in the PELI1 gene are major risk factors for the development of CALs, whereas low serumalbumin concentration is an independent risk factor for IVIG nonresponsiveness.

AB - Kawasaki disease (KD) is the most common cause of acquired heart disease in children. Intravenous immunoglobulin (IVIG) is the standard therapy for KD, but more than 10% ofKDpatients do not respond to IVIG and are at high risk for the development of coronary artery lesions (CALs). To identify clinical and genetic risk factors associated with CAL development and IVIG nonresponsiveness, this study analyzed the clinical data for 478 Korean KD patients. Multivariate logistic regression analysis showed that incomplete KD, IVIG nonresponse, fever duration of 7 days or longer, and the CC/ACgenotypes of the rs7604693 single nucleotide polymorphism (SNP) in the PELI1 gene were significantly associated with the development of CALs, with odds ratios (ORs) ranging from 2.06 to 3.04. The risk of CAL formation was synergistically increased by the addition of individual risk factors, particularly the genetic variant in the PELI1 gene. Multivariate analysis also showed that a serum albumin level of 3.6 g/dl or lower was significantly associated with nonresponsiveness to IVIG [OR, 2.76; 95% confidence interval (CI), 1.34-5.68; P = 0.006]. Conclusively, incomplete KD, IVIG nonresponsiveness, long febrile days, and the rs7604693 genetic variant in the PELI1 gene are major risk factors for the development of CALs, whereas low serumalbumin concentration is an independent risk factor for IVIG nonresponsiveness.

KW - Coronary artery lesions

KW - Intravenous immunoglobulin

KW - Kawasaki disease

KW - Korean

KW - PELI1 gene

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SN - 0172-0643

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JO - Pediatric Cardiology

JF - Pediatric Cardiology

IS - 4

ER -

Assessment of risk factors for Korean children with Kawasaki disease

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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