Hepatic dysfunction secondary to Kawasaki disease: characteristics, etiology and predictive role in coronary artery abnormalities.
Coronary artery abnormalities
Hepatic dysfunction
Hypoalbuminemia
Kawasaki disease
Multivariate analysis
Journal
Clinical and experimental medicine
ISSN: 1591-9528
Titre abrégé: Clin Exp Med
Pays: Italy
ID NLM: 100973405
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
26
09
2019
accepted:
14
11
2019
pubmed:
18
11
2019
medline:
2
10
2020
entrez:
18
11
2019
Statut:
ppublish
Résumé
Coronary artery abnormalities (CAAs) are prominent during the acute Kawasaki disease (KD) episode and represent the major contributors to the long-term prognosis. Several meta-analysis and published scoring systems have identified hepatic dysfunction as an independent predictor of CAA risks. The medical records of 210 KD children were reviewed. Blood samples were collected from all subjects at 24 h pre-therapy and 48 h post-therapy, respectively. Liver function test (LFT) and inflammatory mediators were detected. Multivariate logistic regression analysis was conducted to identify the reliable biomarkers predicting whether CAAs existed or not in KD patients. 90.95% of KD patients had at least 1 abnormal LFT. Hypoalbuminemia was the most prevalent type of hepatic dysfunction, followed by elevated aspartate aminotransferase, low TP, low A/G and hyperbilirubinemia, respectively. The elevated inflammatory mediators (procalcitonin and C-reactive protein) and moderate dose of aspirin played a synthetic role in hepatic dysfunction secondary to KD. However, LFT presented no significant differences between infectious and noninfectious conditions. By a multivariate analysis, a lower albumin/globulin ratio (A/G, OR 13.50, 95% CI 3.944-46.23) served as an independent predictor of CAAs and had a sensitivity of 56.25%, and a specificity of 61.11% at a cutoff value of < 1.48. In conclusion, hepatic dysfunction is a common complication during the acute KD episode, characterized by elevated serum liver enzymes, hypoalbuminemia and hyperbilirubinemia. Systemic inflammation and aspirin, rather than infectious agents, are both the major contributors of hepatic dysfunction secondary to KD. A lower A/G serves as an independent predictor of CAAs.
Identifiants
pubmed: 31734766
doi: 10.1007/s10238-019-00596-1
pii: 10.1007/s10238-019-00596-1
doi:
Substances chimiques
Biomarkers
0
Procalcitonin
0
C-Reactive Protein
9007-41-4
Aspartate Aminotransferases
EC 2.6.1.1
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
21-30Subventions
Organisme : New Technology Project of the First Affiliated Hospital, Anhui Medical University
ID : 2014-01
Références
Wu MH, Lin MT, Chen HC, Kao FY, Huang SK. Postnatal risk of acquiring Kawasaki disease: a nationwide birth cohort database study. J Pediatr. 2017;180:80–6.
pubmed: 27817879
doi: 10.1016/j.jpeds.2016.09.052
Makino N, Nakamura Y, Yashiro M, et al. Descriptive epidemiology of Kawasaki disease in Japan, 2011–2012: from the results of the 22nd nationwide survey. J Epidemiol. 2015;25:239–45.
pubmed: 25716368
doi: 10.2188/jea.JE20140089
McCrindle BW, Rowley AH, Newburger JW, et al. American heart association rheumatic fever, endocarditis, and kawasaki disease committee of the council on cardiovascular disease in the young; council on cardiovascular and stroke nursing; council on cardiovascular surgery and anesthesia; and council on epidemiology and prevention. Diagnosis, treatment, and long-term management of kawasaki disease: a scientific statement for health professionals from the american heart association. Circulation. 2017;135:e927–99.
pubmed: 28356445
doi: 10.1161/CIR.0000000000000484
Hu P, Jiang GM, Wu Y, et al. TNF-α is superior to conventional inflammatory mediators in forecasting IVIG nonresponse and coronary arteritis in Chinese children with Kawasaki disease. Clin Chim Acta. 2017;471:76–80.
pubmed: 28526535
doi: 10.1016/j.cca.2017.05.019
Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease. A 10-to 21-year follow-up study of 594 patients. Circulation. 1996;94:1379–85.
pubmed: 8822996
doi: 10.1161/01.CIR.94.6.1379
Kobayashi T, Inoue Y, Takeuchi K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation. 2006;113:2606–12.
pubmed: 16735679
doi: 10.1161/CIRCULATIONAHA.105.592865
Egami K, Muta H, Ishii M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease. J Pediatr. 2006;149:237–40.
pubmed: 16887442
doi: 10.1016/j.jpeds.2006.03.050
Bai L, Feng T, Yang L, et al. Retrospective analysis of risk factors associated with Kawasaki disease in China. Oncotarget. 2017;8:54357–63.
pubmed: 28903347
pmcid: 5589586
Eladawy M, Dominguez SR, Anderson MS, Glodé MP. Abnormal liver panel in acute kawasaki disease. Pediatr Infect Dis J. 2011;30:141–4.
pubmed: 20861758
pmcid: 3096016
doi: 10.1097/INF.0b013e3181f6fe2a
Kobayashi T, Fuse S, Sakamoto N, et al. Z Score Project Investigators. A new Z score curve of the coronary arterial internal diameter using the lambda-mu-sigma method in a pediatric population. J Am Soc Echocardiogr. 2016;29:794–801.
pubmed: 27288089
doi: 10.1016/j.echo.2016.03.017
Wu Y, Liu FF, Xu Y, et al. Interleukin-6 is prone to be a candidate biomarker for predicting incomplete and IVIG nonresponsive Kawasaki disease rather than coronary artery aneurysm. Clin Exp Med. 2019;19:173–81.
pubmed: 30617865
doi: 10.1007/s10238-018-00544-5
Burns JC, Glodé MP. Kawasaki syndrome. Lancet. 2004;364:533–44.
pubmed: 15302199
doi: 10.1016/S0140-6736(04)16814-1
Tizard E. Complications of Kawasaki disease. Curr. Paediatr. 2005;15:62–8.
Ohshio G, Furukawa F, Fujiwara H, Hamashima Y. Hepatomegaly and splenomegaly in Kawasaki disease. Pediatr Pathol. 1985;4:257–64.
pubmed: 3835550
doi: 10.3109/15513818509026899
Bader-Meunier B, Hadchouel M, Fabre M, Arnoud MD, Dommergues JP. Intrahepatic bile duct damage in children with Kawasaki disease. J Pediatr. 1992;120:750–2.
pubmed: 1578309
doi: 10.1016/S0022-3476(05)80239-2
Tremoulet AH, Jain S, Chandrasekar D, Sun X, Sato Y, Burns JC. Evolution of laboratory values in patients with Kawasaki disease. Pediatr Infect Dis J. 2011;30:1022–6.
pubmed: 21817952
pmcid: 3222731
doi: 10.1097/INF.0b013e31822d4f56
Okada Y, Minakami H, Tomomasa T, et al. Serum procalcitonin concentration in patients with Kawasaki disease. J Infect. 2004;48:199–205.
pubmed: 14720497
doi: 10.1016/j.jinf.2003.08.002
Samadli S, Liu FF, Mammadov G, et al. The time option of IVIG treatment is associated with therapeutic responsiveness and coronary artery abnormalities but not with clinical classification in the acute episode of Kawasaki disease. Pediatr Rheumatol Online J. 2019;17:53.
pubmed: 31366406
pmcid: 6668082
doi: 10.1186/s12969-019-0352-3
Si F, Wu Y, Gao F, Feng S, Liu R, Yi Q. Relationship between IL-27 and coronary arterial lesions in children with Kawasaki disease. Clin Exp Med. 2017;17:451–7.
pubmed: 28108813
doi: 10.1007/s10238-017-0451-8
Su Y, Feng S, Luo L, Liu R, Yi Q. Association between IL-35 and coronary arterial lesions in children with Kawasaki disease. Clin Exp Med. 2019;19:87–92.
pubmed: 30054763
doi: 10.1007/s10238-018-0513-6
Amano S, Hazama F, Hamashima Y. Pathology of Kawasaki disease: II. Distribution and incidence of the vascular lesions. Jpn Circ J. 1979;43:741-8.
pubmed: 41114
doi: 10.1253/jcj.43.741
Seki S, Habu Y, Kawamura T, et al. The liver as a crucial organ in the first line of host defense: the roles of Kupffer cells, natural killer (NK) cells and NK1.1 Ag + T cells in T helper 1 immune responses. Immunol Rev. 2000;174:35–46.
pubmed: 10807505
doi: 10.1034/j.1600-0528.2002.017404.x
Ishihara K, Miyazaki A, Nabe T, et al. Group IVA phospholipase A2 participates in the progression of hepatic fibrosis. FASEB J. 2012;26:4111–21.
pubmed: 22750514
doi: 10.1096/fj.12-205625
Zalewski A, Macphee C. Role of lipoprotein-associated phospholipase A2 in atherosclerosis: biology, epidemiology, and possible therapeutic target. Arterioscler Thromb Vasc Biol. 2005;25:923–31.
pubmed: 15731492
doi: 10.1161/01.ATV.0000160551.21962.a7
Tanaseanu C, Tudor S, Tamsulea I, Marta D, Manea G, Moldoveanu E. Vascular endothelial growth factor, lipoporotein-associated phospholipase A2, sP-selectin and antiphospholipid antibodies, biological markers with prognostic value in pulmonary hypertension associated with chronic obstructive pulmonary disease and systemic lupus erithematosus. Eur J Med Res. 2007;12:145–51.
pubmed: 17509958
Prete M, Fatone MC, Vacca A, Racanelli V, Perosa F. Severe pulmonary hypertension as the initial manifestation of systemic lupus erythematosus: a case report and review of the literature. Clin Exp Rheumatol. 2014;32:267–74.
pubmed: 24351505
Sauer M, Doß S, Ehler J, Mencke T, Wagner NM. Procalcitonin impairs liver cell viability and function in vitro: a potential new mechanism of liver dysfunction and failure during sepsis? Biomed Res Int. 2017;2017:6130725.
pubmed: 28255555
pmcid: 5309405
doi: 10.1155/2017/6130725
Principi N, Rigante D, Esposito S. The role of infection in Kawasaki syndrome. J Infect. 2013;67:1–10.
pubmed: 23603251
doi: 10.1016/j.jinf.2013.04.004
pmcid: 7132405
Hall M, Hoyt L, Ferrieri P, Schlievert PM, Jenson HB. Kawasaki syndrome-like illness associated with infection caused by enterotoxin B-secreting Staphylococcus aureus. Clin Infect Dis. 1999;29:586–9.
pubmed: 10530452
doi: 10.1086/598638
Matsubara K, Fukaya T, Miwa K, et al. Development of serum IgM antibodies against superantigens of Staphylococcus aureus and Streptococcus pyogenes in Kawasaki disease. Clin Exp Immunol. 2006;143:427–34.
pubmed: 16487241
pmcid: 1809617
doi: 10.1111/j.1365-2249.2006.03015.x
Kanegane H, Tsuji T, Seki H, et al. Kawasaki disease with a concomitant primary Epstein-Barr virus infection. Acta Paediatr Jpn. 1994;36:713–6.
pubmed: 7871990
doi: 10.1111/j.1442-200X.1994.tb03277.x
Embil JA, McFarlane ES, Murphy DM, Krause VW, Stewart HB. Adenovirus type 2 isolated from a patient with fatal Kawasaki disease. Can Med Assoc J. 1985;132:1400.
pubmed: 4005729
pmcid: 1346107
Hagiwara K, Komura H, Kishi F, Kaji T, Yoshida T. Isolation of human herpesvirus-6 from an infant with Kawasaki disease. Eur J Pediatr. 1992;151:867–8.
pubmed: 1334835
doi: 10.1007/BF01957946
Johnson D, Azimi P. Kawasaki disease associated with Klebsiella pneumoniae bacteremia and parainfluenza type 3 virus infection. Pediatr Infect Dis. 1985;4:100.
pubmed: 2982131
doi: 10.1097/00006454-198501000-00024
Matsuno S, Utagawa E, Sugiura A. Association of rotavirus infection with Kawasaki syndrome. J Infect Dis. 1983;148:177.
pubmed: 6309994
doi: 10.1093/infdis/148.1.177
Hu P, Wang J, Fan XC, Hu B, Lu L. Hypertension triggers the rupture of coronary artery aneurysm in an 8-year-old boy with Kawasaki disease. J Clin Hypertens (Greenwich). 2014;16:766–7.
doi: 10.1111/jch.12394
pmcid: 8031575
Hu P, Guan Y, Fan XC, Lu FY, Song LM. Incomplete Kawasaki disease induced by measles in a 6-month-old male infant. Int J Dermatol. 2016;55:e34–6.
pubmed: 26518488
doi: 10.1111/ijd.13122
Peng Y, Liu X, Duan Z, et al. Prevalence and characteristics of arthritis in Kawasaki disease: a Chinese cohort study. Clin Exp Med. 2019;19:167–72.
pubmed: 30725203
doi: 10.1007/s10238-019-00547-w
Jordan-Villegas A, Chang ML, Ramilo O, Mejías A. Concomitant respiratory viral infections in children with Kawasaki disease. Pediatr Infect Dis J. 2010;29:770–2.
pubmed: 20354462
pmcid: 2927322
doi: 10.1097/INF.0b013e3181dba70b
Ramphul K, Mejias SG. Kawasaki disease: a comprehensive review. Arch Med Sci Atheroscler Dis. 2018;3:e41–5.
pubmed: 30775588
pmcid: 6374576
doi: 10.5114/amsad.2018.74522
Onouchi Z, Kawasaki T. Overview of pharmacological treatment of Kawasaki disease. Drugs. 1999;58:813–22.
pubmed: 10595862
doi: 10.2165/00003495-199958050-00004
Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS. Salicylate for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev. 2006;4:CD004175.
Matsubara T, Mason W, Kashani IA, Kligerman M, Burns JC. Gastrointestinal hemorrhage complicating aspirin therapy in acute Kawasaki disease. J Pediatr. 1996;128:701–3.
pubmed: 8627447
doi: 10.1016/S0022-3476(96)80140-5
Lee JH, Hung HY, Huang FY. Kawasaki disease with Reye syndrome: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1992;33:67–71.
pubmed: 1626454
Aithal GP, Day CP. Nonsteroidal anti-inflammatory drug-induced hepatotoxicity. Clin Liver Dis. 2007;11:563–75.
pubmed: 17723920
doi: 10.1016/j.cld.2007.06.004
Chen J, Liu Y, Liu W, Wu Z. A meta-analysis of the biomarkers associated with coronary artery lesions secondary to Kawasaki disease in Chinese children. J Huazhong Univ Sci Technolog Med Sci. 2011;31:705.
pubmed: 22038366
doi: 10.1007/s11596-011-0587-9
Lin MT, Chang CH, Sun LC, et al. Risk factors and derived formosa score for intravenous immunoglobulin unresponsiveness in Taiwanese children with Kawasaki disease. J Formos Med Assoc. 2016;115:350–5.
pubmed: 25910931
doi: 10.1016/j.jfma.2015.03.012
Tang Y, Yan W, Sun L, et al. Prediction of intravenous immunoglobulin resistance in Kawasaki disease in an East China population. Clin Rheumatol. 2016;35:2771–6.
pubmed: 27491972
doi: 10.1007/s10067-016-3370-2
Hua W, Ma F, Wang Y, et al. A new scoring system to predict Kawasaki disease with coronary artery lesions. Clin Rheumatol. 2019;38:1099–107.
pubmed: 30523553
doi: 10.1007/s10067-018-4393-7
Kuwabara M, Yashiro M, Kotani K, et al. Cardiac lesions and initial laboratory data in Kawasaki disease: a nationwide survey in Japan. J Epidemiol. 2015;25:189–93.
pubmed: 25716055
doi: 10.2188/jea.JE20140128
Nicholson JP, Wolmarans MR, Park GR. The role of albumin in critical illness. Br J Anaesth. 2000;85:599–610.
pubmed: 11064620
doi: 10.1093/bja/85.4.599
Ballmer PE. Causes and mechanisms of hypoalbuminaemia. Clin Nutr. 2001;20:271–3.
pubmed: 11407876
doi: 10.1054/clnu.2001.0439