Relationship between Electrolyte Abnormalities, ESR, CRP and platelet count with Severity of Kawasaki Disease

Kawasaki disease (KD) is an acute febrile vasculitis of childhood occurs worldwide, with Asians at highest risk. Approximately 20% of untreated patients develop coronary artery abnormalities including aneurysms, myocardial infarction and sudden death. KD is the common cause of acquired heart disease in children in the United States and Japan. The aim of this study was to determine the severity of kawasaki disease based on laboratory and echocardiographic findings. In this cross-sectional research, we studied records of all patients (n=61) admitted to Mofid Children’s hospital with Kawasaki disease from December 21, 2004 to January 21, 2008. Patients with exclusion criteria were omitted (n=11) and other 50 patients were entered the study. At least three CFM echocardiograms were performed for all of these children with Kawasaki disease: at diagnosis, after 2-3 wk and 6-8 wk after onset of illness. These CFM echocardiograms was performed only by one Paediatric cardiologist (he didn’t have any information about severity and other characteristics of the disease in these patients). All patients were followed up for 12 weeks after discharge. There were 32(64%) boys and 18(36%) girls in this study (total number: 50). The male to female ratio was 1. 8: 1. 100% of the patients had fever, 82% changes in oral cavity & lips, 78% bilateral bulbar conjunctival injection, 64% changes of the peripheral extremities, 58% polymorphous rash and 40% cervical adenopathy. Coronary artery aneurysm was seen in 2% of the patients. No recurrence of KD was observed among these children. Based on laboratory and echocardiographic findings, the patients divided into two groups: severe (n=24) and non-severe (n=26). Mean age of the children, mean duration of hospitalization and rash were significantly higher in the severe group. There was no significant difference between number of patients with K<3. 4mEq/L in two groups. Number of patients with Na<135mEq/L was significantly higher in the severe group (p=0. 01). Mitral regurgitation and 2-times receiving IVIG were significantly higher in the severe group (p=0. 02 and p=0. 008, respectively). Our data demonstrated that sooner performance of CFM echocardiogram and ESR, CRP, Platelet count and Na levels can help us to detect severe Kawasaki disease easer & faster.