Hyponatremia May Reflect Severe Inflammation in Children with Kawasaki Disease
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Purpose: The aim of the present study was to investigate the risk factors for the development of coronary artery lesions (CALs) and to determine whether hyponatremia is associated with CALs in children with Kawasaki disease (KD). Methods: We retrospectively analyzed the data of 105 children with KD who were admitted to Ilsan Hospital between January 2000 and July 2011. Results: Erythrocyte sedimentation rate (P = 0.013), total bilirubin levels (P = 0.017) were higher and serum sodium levels (P = 0.027) were lower in KD children with CALs than those without. White blood cell (WBC) counts (P = 0.006), neutrophil counts (P = 0.003) were higher and albumin levels (P = 0.009) were lower in KD children with hyponatremia than those without. On multiple logistic regression analysis, hyponatremia (P = 0.024) and intravenous immunoglobulin– resistance (P = 0.024) were independent risk factors for CALs in KD. Furthermore, serum sodium levels were correlated negatively with WBC counts (P = 0.004), neutrophil counts (P < 0.001), total bilirubin levels (P = 0.005) and positively with albumin levels (P = 0.009). Conclusion: Our study indicates that hyponatremia may reflect severe inflammation in children with KD.
Abstract
Purpose: The aim of the present study was to investigate the risk factors for the development of coronary artery lesions (CALs) and to determine whether hyponatremia is associated with CALs in children with Kawasaki disease (KD). Methods: We retrospectively analyzed the data of 105 children with KD who were admitted to Ilsan Hospital between January 2000 and July 2011. Results: Erythrocyte sedimentation rate (P = 0.013), total bilirubin levels (P = 0.017) were higher and serum sodium levels (P = 0.027) were lower in KD children with CALs than those without. White blood cell (WBC) counts (P = 0.006), neutrophil counts (P = 0.003) were higher and albumin levels (P = 0.009) were lower in KD children with hyponatremia than those without. On multiple logistic regression analysis, hyponatremia (P = 0.024) and intravenous immunoglobulin– resistance (P = 0.024) were independent risk factors for CALs in KD. Furthermore, serum sodium levels were correlated negatively with WBC counts (P = 0.004), neutrophil counts (P < 0.001), total bilirubin levels (P = 0.005) and positively with albumin levels (P = 0.009). Conclusion: Our study indicates that hyponatremia may reflect severe inflammation in children with KD.
참고문헌 (23)
- Burns JC, "Kawasaki syndrome", Lancet, 364, pp.533~544 (2004)
- Burns JC, "Kawasaki disease", Adv Pediatr, 48, pp.157~177 (2001)
- Chen J, "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, 31, pp.705~711 (2011)
- Kuwabara M, "Cardiac lesions and initial laboratory data in Kawasaki disease : a nationwide survey in Japan", J Epidemiol, 25, pp.189~193 (2015)
- Laxer RM, "Hyponatremia in Kawasaki disease", Pediatrics, 70, pp.655~ (1982)
- Watanabe T, "Hyponatremia in Kawasaki disease", Pediatr Nephrol, 21, pp.778~781 (2006)
- 임고은, "Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Kawasaki Disease", Korean Circulation Journal, 40(10), pp.507~513 (2010), 대한심장학회
- Mori J, "Syndrome of inappropriate anti-diuretic hormone in Kawasaki disease", Pediatr Int, 53, pp.354~357 (2011)
- Nakamura Y, "Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease", Pediatr Int, 46, pp.33~38 (2004)
- Arjunan K, "Coronary artery caliber in normal children and patients with Kawasaki disease but without aneurysms : an echocardiographic and angiographic study", J Am Coll Cardiol, 8, pp.1119~1124 (1986)
- Takahashi M, "Regression of coronary aneurysms in patients with Kawasaki syndrome", Circulation, 75, pp.387~394 (1987)
- Kobayashi T, "Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease", Circulation, 113, pp.2606~2612 (2006)
- Yi DY, "Hepatobiliary risk factors for clinical outcome of Kawasaki disease in children", BMC Pediatr, 14, pp.51~ (2014)
- Eladawy M, "Abnormal liver panel in acute kawasaki disease", Pediatr Infect Dis J, 30, pp.141~144 (2011)
- Davies S, "Predicting IVIG resistance in UK", Kawasaki disease, 100, pp.366~368 (2015)
- Sano T, "Prediction of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment", Eur J Pediatr, 166, pp.131~137 (2007)
- Shin JI, "Kawasaki disease and hyponatremia", Pediatr Nephrol, 21, pp.1490~1491 (2006)
- Mastorakos G, "Hypothalamic-pituitary-adrenal axis activation and stimulation of systemic vasopressin secretion by recombinant interleukin-6in humans : potential implications for the syndrome of inappropriate vasopressin secretion", J Clin Endocrinol Metab, 79, pp.934~939 (1994)
- Eisenhut M, "Changes in renal sodium transport during a systemic inflammatory response", Pediatr Nephrol, 21, pp.1487~1488 (2006)
- Maruyama K, "Reversible secondary pseudohypoaldosteronism due to pyelonephritis", Pediatr Nephrol, 17, pp.1069~1070 (2002)
- Watanabe T, "Kidney and urinary tract involvement in kawasaki disease", Int J Pediatr, 2013, pp.831834~ (2013)
- Lin KH, "Usefulness of natriuretic peptide for the diagnosis of Kawasaki disease:a systematic review and meta-analysis", 5, pp.e006703~ (2015)
- Iwashima S, "B-type natriuretic peptide and N-terminal pro-BNP in the acute phase of Kawasaki disease", World J Pediatr, 9, pp.239~244 (2013)