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Background: Kawasaki disease (KD) may cause cardiac and coronary complications. Since definite markers to accurately predict coronary involvement is not present, we aimed to analyze the role of hematological indices [neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), and mean platelet volume (MPV)-to lymphocyte ratio (MPVLR)], prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in predicting coronary involvement of KD. Patients The medical records of 134 KD patients admitted between January 2008 and December 2019 were investigated. Also, 268 age-matched healthy controls (HCs) were included in the study., Methods: KD patients were divided into two groups: KD with coronary artery lesions (KD-CALs) and KD without CALs. Logistic regression analysis was performed to determine parameters that may predict coronary involvement in children with KD., Results: Among KD patients, 39 (29.1%) had CALs. When compared with HCs, the median levels of WBC, neutrophils, monocytes, eosinophils, platelets, MPV and, the values of NLR, PLR, MPVLR, SII were significantly higher; whereas lymphocyte count, PNI, platelet distribution width (PDW), LMR were markedly lower in the KD group (p˂0.001 for all, except for p=0.010 for eosinophil count). The CALs group's SII, PLR, and PNI values were significantly lower than those without (p=0.030, p=0.032, and p ˂0.001; respectively). Multivariable regression analysis revealed that PNI, SII, and gender (male) were associated with CALs in KD., Conclusion: Our analysis revealed that male sex, lower PNI, and lower SII levels were independently associated with CALs in children with KD., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.) more...

Objective Kawasaki disease (KD) is an acute systemic vasculitis that is one of the major causes of acquired heart disease especially in young children. The pathogenesis of KD is still unclear. The increased incidence of the disease among Japanese children and siblings of affected patients suggests a genetic component to KD susceptibility. Several reports have studied human leukocyte antigen (HLA) polymorphisms in different populations with KD and found various results. In the present study, we aimed to evaluate the association of HLA-A, -B, -C, -DRB1, and -DQB1 allele frequencies in Turkish children with KD. Methods The study was conducted between January 2016 and February 2018. HLA Class I (A, B, and C) and Class II (DRB1 and DQB1) alleles of patients and healthy controls were studied using the low-resolution DNA-based sequence-specific oligonucleotide method. Results Fifty children with KD and 500 healthy controls were included in this study. In the analysis of HLA-A, HLA-B, HLA-C, and HLA-DRB1 alleles, no statistical difference was found in the frequency of alleles between the patients with KD and the control group. However, a significantly lower frequency of the HLA-DQB1*03 allele was observed in the KD group than in the control group (p < 0.001, odds ratio [OR]: 0.29, 95% confidence interval [CI]: 0.15–0.55). When the patients with KD were divided into two subgroups with or without coronary artery lesions (CALs), the frequency of the HLA-DQB1*03 allele was also found lower in the KD group with CALs than the KD group without CALs (p = 0.008, OR: 0.19, 95% CI: 0.05–0.68). Conclusion The study may guide future studies on HLA-DQB1*03 whether it is a protective allele for KD and CALs in Turkish children. [ABSTRACT FROM AUTHOR] more...

Aim: Kawasaki disease (KD) is difficult to diagnose in infants, since the disease course is subtle. We aimed to identify whether infants with KD demonstrate significant alterations in laboratory parameters that can be used to distinguish them from other febrile infants. Materials and Methods: In this retrospective case-control study, infants diagnosed with KD between January 2010 and December 2019 were evaluated and compared to a cohort of febrile infants admitted with prolonged fever during the same period. Demographic, clinical, and laboratory features were recorded and compared between these two groups. Results: A total of 42 infants (27 male) with KD (32 incomplete KD) and 84 age-matched febrile infants (57 male) were evaluated. Coronary artery involvement was identified in 20 (47.6%) infants of whom 5 (25%) had coronary aneurysms. All infants with KD were treated with IVIG and high dose acetylsalicylic acid, and 38 (90.5%) responded to treatment. The duration of fever and hospitalization were longer in infants with KD compared to the controls (p<0.001). White blood cell (WBC), eosinophil, platelet counts, platelet distribution width, acute phase reactants, alanine aminotransferase, and gamma glutamyl transferase were significantly higher; whereas, mean platelet volume (MPV), hemoglobin, and albumin levels were lower in the KD group compared to the controls. Lower MPV and albumin values were found to be independently associated with a higher likelihood of having a KD diagnosis. Conclusion: It may be difficult to diagnose KD in infants. Our data shows that MPV and albumin may be used as supportive parameters to differentiate KD from other febrile conditions in infants. [ABSTRACT FROM AUTHOR] more...

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