A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease
Background: Kawasaki disease, the commonest cause of multisystem vasculitis in children, was believed initially as a one-time disease. Long-term follow-up reveals that endothelial dysfunction persists in post-Kawasaki disease patients with and without coronary lesions and predisposes to atherosclero...
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SAGE Publishing
2022-01-01
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| Series: | Indian Journal of Rheumatology |
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| Online Access: | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2022;volume=17;issue=1;spage=24;epage=29;aulast= |
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| author | Malabika Maity Debadatta Mukhopadhyay Tapas Sabui Rakesh Mondal Jiban Krishna De |
| author_facet | Malabika Maity Debadatta Mukhopadhyay Tapas Sabui Rakesh Mondal Jiban Krishna De |
| author_sort | Malabika Maity |
| collection | DOAJ |
| description | Background: Kawasaki disease, the commonest cause of multisystem vasculitis in children, was believed initially as a one-time disease. Long-term follow-up reveals that endothelial dysfunction persists in post-Kawasaki disease patients with and without coronary lesions and predisposes to atherosclerosis.
Aims and Objectives: To establish the endothelial dysfunction and to correlate it with premature atherosclerosis in Kawasaki disease patients.
Settings and Design: Prospective comparative study.
Materials and Methods: Thirty patients of Kawasaki disease (age, 6 months to 20 years) were compared to the age matched control population and evaluated 2 times (1st F/U and 2nd F/U) at an interval of 6 months. USG Doppler was used to measure intimal thickness of carotid arteries CAD-IT, flow character and Resistive Index of anterior ATA-RI and posterior tibial arteries PTA-RI. Echocardiography was used to detect perivascular hyperintensity, dilatation and aneurysm of coronary arteries. Ongoing inflammation was documented by C- reactive protein (CRP) level. Coronary involvement (dilatation, small, medium, giant CAA) was determined by the z-scores adjusted to patients' body surface area (BSA) (AHA guidelines 2017).
Statistical analysis used: Mean, paired t-test, GEE model, Odds ratio.
Results: Significantly elevated CRP levels were observed in both the 1st follow up (p=0.0005) and 2nd follow up (p=0.000001) compared to control value. A significant rise (p<0.05) in total cholesterol, triglyceride levels, ATA-RI, PTA-RI and CAD-IT were seen. Seven patients developed coronary aneurysm of which three had persistent lesion.
Conclusions: Kawasaki disease is not a one -time disease. Persistent endothelial dysfunction continues. CRP, total cholesterol, triglyceride, and USG doppler of coronary, carotids as well as peripheral arteries were found abnormal in follow up. So, these patients need to be followed up for a long period. |
| format | Article |
| id | doaj-art-c42e36825ee143d0afbae78726866bd2 |
| institution | OA Journals |
| issn | 0973-3698 0973-3701 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
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| series | Indian Journal of Rheumatology |
| spelling | doaj-art-c42e36825ee143d0afbae78726866bd22025-08-20T01:47:45ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012022-01-01171242910.4103/injr.injr_263_20A comparative study to assess vascular health in previously diagnosed patients of kawasaki diseaseMalabika MaityDebadatta MukhopadhyayTapas SabuiRakesh MondalJiban Krishna DeBackground: Kawasaki disease, the commonest cause of multisystem vasculitis in children, was believed initially as a one-time disease. Long-term follow-up reveals that endothelial dysfunction persists in post-Kawasaki disease patients with and without coronary lesions and predisposes to atherosclerosis. Aims and Objectives: To establish the endothelial dysfunction and to correlate it with premature atherosclerosis in Kawasaki disease patients. Settings and Design: Prospective comparative study. Materials and Methods: Thirty patients of Kawasaki disease (age, 6 months to 20 years) were compared to the age matched control population and evaluated 2 times (1st F/U and 2nd F/U) at an interval of 6 months. USG Doppler was used to measure intimal thickness of carotid arteries CAD-IT, flow character and Resistive Index of anterior ATA-RI and posterior tibial arteries PTA-RI. Echocardiography was used to detect perivascular hyperintensity, dilatation and aneurysm of coronary arteries. Ongoing inflammation was documented by C- reactive protein (CRP) level. Coronary involvement (dilatation, small, medium, giant CAA) was determined by the z-scores adjusted to patients' body surface area (BSA) (AHA guidelines 2017). Statistical analysis used: Mean, paired t-test, GEE model, Odds ratio. Results: Significantly elevated CRP levels were observed in both the 1st follow up (p=0.0005) and 2nd follow up (p=0.000001) compared to control value. A significant rise (p<0.05) in total cholesterol, triglyceride levels, ATA-RI, PTA-RI and CAD-IT were seen. Seven patients developed coronary aneurysm of which three had persistent lesion. Conclusions: Kawasaki disease is not a one -time disease. Persistent endothelial dysfunction continues. CRP, total cholesterol, triglyceride, and USG doppler of coronary, carotids as well as peripheral arteries were found abnormal in follow up. So, these patients need to be followed up for a long period.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2022;volume=17;issue=1;spage=24;epage=29;aulast=atherosclerosisendothelial dysfunctionkawasaki diseasez-score |
| spellingShingle | Malabika Maity Debadatta Mukhopadhyay Tapas Sabui Rakesh Mondal Jiban Krishna De A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease Indian Journal of Rheumatology atherosclerosis endothelial dysfunction kawasaki disease z-score |
| title | A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| title_full | A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| title_fullStr | A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| title_full_unstemmed | A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| title_short | A comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| title_sort | comparative study to assess vascular health in previously diagnosed patients of kawasaki disease |
| topic | atherosclerosis endothelial dysfunction kawasaki disease z-score |
| url | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2022;volume=17;issue=1;spage=24;epage=29;aulast= |
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