Pediatric Emergency Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria, Polyclinic of St.Orsola, University of Bologna, 40138, Bologna, Italy.
Specialty School of Paediatrics, Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy.
Sci Rep. 2022 May 23;12(1):8640. doi: 10.1038/s41598-022-12702-7.
Kawasaki Disease (KD) is systemic vasculitis involving medium-sized vessels in children. The aim of our study is to determine if fecal calprotectin (FC) could be useful in predicting the development or persistence of coronary artery lesions (CALs) in KD. We conducted a prospective monocentric study including all consecutive diagnoses of. Clinical, laboratory, echocardiographic data were recorded during the acute and subacute phase, including FC. Correlations among laboratory values, FC, clinical manifestations, IVIG-responsiveness and CALs development were investigated. We enrolled 26 children (76.9% boys; median age 34.5 months). The combination of FC > 250 microg/g and z-score > 2 during the acute phase was associated with the persistence of CALs (p = 0.022). A z-score > 2 alone during the acute phase was not related to CALs during the subacute stage (p > 0.05). A neutrophil percentage > 70% and WBC > 15,000/mmc during the acute phase significantly correlated with the presence of CALs during the subacute phase (p = 0.008). C-reactive protein (CRP) > 13 mg/dL at KD onset was significantly associated with the presence of CALs during the acute (p = 0.017) and subacute phase (p = 0.001). The combination of FC > 250 microg/g and a z-score > 2 during the acute phase of KD may be used as a predictor of CALs persistence. It can be useful especially in children with an initial CRP < 13 mg/dl.
川崎病（KD）是一种累及儿童中型血管的全身性血管炎。我们的研究目的是确定粪便钙卫蛋白（FC）是否可用于预测 KD 中冠状动脉损伤（CALs）的发展或持续存在。我们进行了一项前瞻性单中心研究，纳入了所有连续诊断为 KD 的患者。在急性期和亚急性期记录临床、实验室和超声心动图数据，包括 FC。研究了实验室值、FC、临床表现、IVIG 反应性和 CALs 发展之间的相关性。我们共纳入 26 例患儿（76.9%为男性；中位年龄 34.5 个月）。急性期 FC>250μg/g 和 z 评分>2 的联合与 CALs 的持续存在相关（p=0.022）。急性期单独的 z 评分>2 与亚急性期的 CALs 无关（p>0.05）。急性期中性粒细胞百分比>70%和 WBC>15,000/mmc 与亚急性期 CALs 的存在显著相关（p=0.008）。KD 发病时 CRP>13mg/dL 与急性期（p=0.017）和亚急性期（p=0.001）CALs 的存在显著相关。KD 急性期 FC>250μg/g 和 z 评分>2 的联合可作为 CALs 持续存在的预测指标。在 CRP<13mg/dL 的患儿中，该方法可能尤其有用。
