ArticlePloS one2018
Gastrointestinal presentation of Kawasaki disease: A red flag for severe disease?
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
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Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 90 citations in OpenAlex.
- The characteristics of the gut microbiota in patients with Kawasaki disease: a systematic review.Frontiers in microbiology · 2025Pooled it
- Gastrointestinal Symptoms in Kawasaki Disease and Multisystem Inflammatory Syndrome in Children.Pediatric cardiology · 2026Article
- Extracriteria manifestations in Kawasaki disease: coronary threat or diagnostic pitfall?European journal of pediatrics · 2026Article
- Etiology Model of Kawasaki Disease and Multisystem Inflammatory Syndromes: Mast Cell Activation.Current issues in molecular biology · 2026Article
- Research on gamma globulin unresponsive Kawasaki disease: A review.World journal of clinical pediatrics · 2025Review
- Unravelling γδ T-cell dysregulation in the gut and its implications for immune-mediated diseases.Disease models & mechanisms · 2025Article
- Risk factors associated with persistent coronary artery lesions in children with Kawasaki disease in an Italian cohort.European journal of pediatrics · 2025Article
- Intestinal Microbiota Contributes to the Development of Cardiovascular Inflammation and Vasculitis in Mice.Circulation research · 2025Article
- Gut Instincts: The Gut Microbiome-Cardiovascular Inflammation Axis.Circulation research · 2025Article
- Gut Microbiota Alterations in Patients With Kawasaki Disease.Arteriosclerosis, thrombosis, and vascular biology · 2025Review
- Clinical characteristics of Kawasaki disease with pulmonary radiographic abnormalities and its impact on the incidence of coronary artery lesions: a randomized retrospective cohort study.Frontiers in pediatrics · 2025Article
- Nutrition-Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta-Analysis.Food science & nutrition · 2025Review
- Article
- The Central Role of Interleukin-1 Signalling in the Pathogenesis of Kawasaki Disease Vasculitis: Path to Translation.The Canadian journal of cardiology · 2024Review
- Analysis of the clinical characteristics of patients with Kawasaki disease complicated with cholestasis.BMC pediatrics · 2024Article
- Coronary Arteries Lesions in Kawasaki Disease: Risk Factors in an Italian Cohort.Biomedicines · 2024Article
- Unraveling the gut: the pivotal role of intestinal mechanisms in Kawasaki disease pathogenesis.Frontiers in immunology · 2024Review
- Unusual Manifestations of Kawasaki Disease in the COVID Era: A Case Series and Review of the Literature.Cureus · 2023Article
- Article
- Kawasaki Disease Associated Acute Abdomen: Most Require No Surgery.Journal of inflammation research · 2023Article
Corrections and comments
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Authors and funding
25 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKawasaki disease (KD) is a febrile systemic vasculitis of unknown etiology and the main cause of acquired heart disease among children in the developed world. To date, abdominal involvement at presentation is not recognized as a risk factor for a more severe form of the disease.
objectiveTo evaluate whether presenting abdominal manifestations identify a group at major risk for Intravenous immunoglobulin (IVIG)-resistance and coronary lesions.
methodsRetrospective study of KD patients diagnosed between 2000 and 2015 in 13 pediatric units in Italy. Patients were divided into 2 groups according to the presence or absence of abdominal manifestations at onset. We compared their demographic and clinical data, IVIG-responsiveness, coronary ectasia/aneurysms, laboratory findings from the acute and subacute phases.
results302 patients (181 boys) were enrolled: 106 patients with, and 196 patients without presenting abdominal features. Seasonality was different between the groups (p = 0.034). Patients with abdominal manifestations were younger (p = 0.006) and more frequently underwent delayed treatment (p = 0.014). In the acute phase, patients with abdominal presentation had higher platelet counts (PLT) (p = 0.042) and lower albuminemia (p = 0.009), while, in the subacute phase, they had higher white blood cell counts (WBC) and PLT (p = 0.002 and p < 0.005, respectively) and lower red blood cell counts (RBC) and hemoglobin (Hb) (p = 0.031 and p 0.009). Moreover, the above mentioned group was more likely to be IVIG-resistant (p < 0.005) and have coronary aneurysms (p = 0.007). In the multivariate analysis, presenting abdominal manifestations, age younger than 6 months, IVIG- resistance, delayed treatment and albumin concentration in the acute phase were independent risk factors for coronary aneurysms (respectively p<0.005, <0.005, = 0.005 and 0.009).
conclusionsThis is the first multicenter report demonstrating that presenting gastrointestinal features in KD identify patients at higher risk for IVIG-resistance and for the development of coronary aneurysms in a predominantly Caucasian population. CLINICAL
trial registration8/20014/O/OssN.
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