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Korean J Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2018.06905    [Accepted]
Published online February 8, 2019.
Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease
Sohyun Kim, Lucy Youngmin Eun 
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Correspondence:  Lucy Youngmin Eun, Tel: +82-2-2019-3350, Fax: +82-2-3461-9473, 
Email: lucyeun@yuhs.ac
Received: 24 August 2018   • Revised: 31 January 2019   • Accepted: 8 February 2019
Coronary artery abnormalities (CAA) are the most important complication of Kawasaki disease (KD). Iron deficiency anemia (IDA) is prevalent micronutrient deficiencies and its association with KD remains unknown. We hypothesized the presence of IDA could be a predictor of CAA.
This retrospective study included 173 KD patients, divided into two groups by absence (Group 1) and presence (Group 2) of CAA. The odds ratio (OR) with 95% confidence interval (CI) was calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to the collinearity between the IDA indicators, each indicator was paired with anemia in 3 models.
The 3 indicators of IDA, serum iron, iron saturation and ferritin, were all significantly higher in Group 1 than in Group 2. Three sets of models including anemia with iron indicators produced the odd ratio (OR) of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The Area under the curve (AUC) of ferritin, iron saturation, serum iron, anemia, and Kobayashi score was 0.907 (95% CI, 0.851–0.963), 0.729 (95% CI, 0.648-0.810), 0.711 (95% CI, 0.629–0.793), 0.638 (95%CI, 0.545-0.731), and 0.563 (95%CI, 0.489-0.636) respectively.
The indicators of IDA, especially ferritin, were highly associated with CAA, so that they were stronger predictors compared to the Kobayashi score. The IDA indicators can be used to predict CAA development and suggest the need for early intervention.
Key Words: Iron deficiency anemia, Kawasaki disease, Coronary artery abnormalities


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