Kawasaki Disease With Gastrointestinal Symptoms In Children:Clinical Characteristics And Factors Associated With Coronary Artery Lesions

Background and ObjectiveKawasaki disease(KD)is a febrile systemic vasculitis of unknown etiology and a common cause of acquired heart disease in children.However,the presence of digestive symptoms in children with Kawasaki disease is not considered a risk factor for coronary artery disease.This article aims to explore the clinical characteristics of gastrointestinal symptoms in children with Kawasaki disease and to analyze the risk factors for coronary artery lesions.MethodsThe clinical data of 269 children with acute phase Kawasaki disease diagnosed clearly in the Department of Pediatrics of the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2020 were collected.According to the presence or absence of combined gastrointestinal symptoms,it was divided into the group with gastrointestinal symptoms of Kawasaki disease and the group without gastrointestinal symptoms of Kawasaki disease.The general data and laboratory indicators of the children in the two groups were compared.Univariate and multivariate logistic regression analyses were used to investigate the risk factors associated with coronary artery damage.ResultsThere were significant differences in age,cervical lymphadenopathy,coronary artery dilation,delayed treatment with intravenous immunoglobulin(IVIG),white blood cell count,immunoglobulin,serum ferritin,hemoglobin,and complement C4 levels between the two groups(P<0.05).The results of univariate analysis showed that the proportion of children with Kawasaki disease with coronary artery lesions was significantly higher in children aged <6 years,with digestive symptoms,time of first IVIG injection ≥10 d,platelets ≥400×109×L-1,and fever duration ≥10d than in children without coronary artery lesions(P<0.05).Multivariate logistic regression analysis showed that the presence of gastrointestinal symptoms(OR=2.807,95% CI: 1.055 to 7.465),age <6 years(OR=3.806,95% CI: 1.094 to 13.234),time of first IVIG injection ≥ 10 d(OR=4.592,95% CI: 1.095 to 19.262),platelets ≥400×109×L-1(OR=6.005,95% CI: 1.619 to 22.273)were risk factors for concomitant coronary artery disease in children with KD(all P <0.05).ConclusionGastrointestinal symptoms in children with Kawasaki disease are more common in infants and young children.Gastrointestinal symptoms,age <6 years,time of first IVIG injection ≥10 d,and platelets≥400×109×L-1 are risk factors for concomitant coronary artery lesions in children with Kawasaki disease.