We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Elevated d-Dimer Level is a Risk Factor for Coronary Artery Lesions Accompanying Intravenous Immunoglobulin-Unresponsive Kawasaki Disease.
- Authors
Masuzawa, Yuko; Mori, Masaaki; Hara, Takuma; Inaba, Aya; Oba, Mari S; Yokota, Shumpei
- Abstract
Although there are many reports on the resistance of Kawasaki disease ( KD) to initial intravenous immunoglobulin ( IVIg) therapy, risk factors for coronary artery lesions in such cases remain to be established. The objective of this study was to explore when additional therapies should be administered and to identify factors helpful for selecting a therapeutic option. Based on their written clinical records, we performed a retrospective review of KD patients who did not respond to initial IVIg therapy and who therefore then underwent plasma exchange ( PE) therapy. This was a case-control study to compare the presence or absence of acute coronary lesions in patients treated by PE for IVIg-unresponsive KD at Yokohama City University Hospital or at Yokohama City University Medical Center. Fifteen of 44 patients had acute coronary artery lesions ( CAL) correlating with high levels of white blood cells ( WBC) ( P = 0.045), d-dimer ( P = 0.008), and fibrin/fibrinogen degradation products ( P = 0.009) and lower levels of fibrinogen ( P = 0.013) prior to PE therapy. There was a strong correlation between pre- PE levels of albumin and d-dimer ( Pearson's correlation coefficient of 0.610). Multivariate analyses revealed that the odds ratio for CAL when d-dimer was ≥ 4.5 μg/mL was 25.06 (95% CI, 2.56-244.91, P = 0.006). d-dimer elevation and albumin decline in IVIg-unresponsive KD patients could be risk factors for acute CAL, suggesting the possibility that angitis has spread throughout the arterial system, as far as the coronary artery.
- Publication
Therapeutic Apheresis & Dialysis, 2015, Vol 19, Issue 2, p171
- ISSN
1744-9979
- Publication type
Article
- DOI
10.1111/1744-9987.12235