Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study

Yao Lin, Yaqi Li, Jingjing Ma, Aijie Li, Yang Liu, Lin Shi Department of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Lin ShiDepartment of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoy...

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Autores principales:	Lin Y, Li Y, Ma J, Li A, Liu Y, Shi L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	kawasaki disease aspirin aspirin-induced urticaria case-control study Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/367dd47d401c489ca6d56498493a7187
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spelling	oai:doaj.org-article:367dd47d401c489ca6d56498493a71872021-11-16T18:47:50ZAspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study1178-7074https://doaj.org/article/367dd47d401c489ca6d56498493a71872021-11-01T00:00:00Zhttps://www.dovepress.com/aspirin-induced-delayed-urticaria-in-children-with-kawasaki-disease-a--peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Yao Lin, Yaqi Li, Jingjing Ma, Aijie Li, Yang Liu, Lin Shi Department of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Lin ShiDepartment of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, People’s Republic of ChinaTel +86-13621096102Email shilinpediatric@outlook.comBackground: Aspirin remains a key component of the standard therapy for Kawasaki disease (KD) in children. Although it is well known that aspirin can cause hypersensitivity such as aspirin-induced urticaria (AIU), AIU in children with KD has not been described.Methods: A retrospective case-control study was conducted to investigate AIU clinical features, biochemical parameters, treatment and outcomes in children with KD. Furthermore, biomarkers for predicting AIU were explored using the receiver operating characteristic (ROC) curve analysis.Results: We identified 46 AIU cases with 22 boys and 24 girls during April 2015–May 2019. Eighty-nine age-matched KD patients without AIU were randomly chosen as controls. The proportions of children with allergy history and aspirin doses administered in the 2 groups were found not to be significantly different. AIU group had substantially higher baseline C-reactive protein and NT-proBNP levels, and increased neutrophil percent. AIU appeared 6.0 (4.0, 8.0) days after aspirin treatment. Aspirin withdrawal and anti-allergic treatment were applied for AIU, and AIU disappeared in 1– 3 days. Baseline NT-proBNP predicted AIU with an AUC of 0.70 (95% CI [0.60 to 0.79]) for sensitivity and specificity of 72.1% and 62.5%, respectively, for a cut-off value of 612.9 mg/L. The length of hospital stay for AIU patients was significantly greater compared with controls.Conclusion: AIU in KD children is not related to gender or aspirin dose, and those with AIU have more severe inflammation at admission. Aspirin should be withdrawn for AIU management. Baseline NT-proBNP may serve as a valuable biomarker to predict AIU.Keywords: Kawasaki disease, aspirin, aspirin-induced urticaria, case-control studyLin YLi YMa JLi ALiu YShi LDove Medical Pressarticlekawasaki diseaseaspirinaspirin-induced urticariacase-control studyMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 8211-8216 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	kawasaki disease aspirin aspirin-induced urticaria case-control study Medicine (General) R5-920
spellingShingle	kawasaki disease aspirin aspirin-induced urticaria case-control study Medicine (General) R5-920 Lin Y Li Y Ma J Li A Liu Y Shi L Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
description	Yao Lin, Yaqi Li, Jingjing Ma, Aijie Li, Yang Liu, Lin Shi Department of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, Beijing, People’s Republic of ChinaCorrespondence: Lin ShiDepartment of Cardiology, Children’s Hospital, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, People’s Republic of ChinaTel +86-13621096102Email shilinpediatric@outlook.comBackground: Aspirin remains a key component of the standard therapy for Kawasaki disease (KD) in children. Although it is well known that aspirin can cause hypersensitivity such as aspirin-induced urticaria (AIU), AIU in children with KD has not been described.Methods: A retrospective case-control study was conducted to investigate AIU clinical features, biochemical parameters, treatment and outcomes in children with KD. Furthermore, biomarkers for predicting AIU were explored using the receiver operating characteristic (ROC) curve analysis.Results: We identified 46 AIU cases with 22 boys and 24 girls during April 2015–May 2019. Eighty-nine age-matched KD patients without AIU were randomly chosen as controls. The proportions of children with allergy history and aspirin doses administered in the 2 groups were found not to be significantly different. AIU group had substantially higher baseline C-reactive protein and NT-proBNP levels, and increased neutrophil percent. AIU appeared 6.0 (4.0, 8.0) days after aspirin treatment. Aspirin withdrawal and anti-allergic treatment were applied for AIU, and AIU disappeared in 1– 3 days. Baseline NT-proBNP predicted AIU with an AUC of 0.70 (95% CI [0.60 to 0.79]) for sensitivity and specificity of 72.1% and 62.5%, respectively, for a cut-off value of 612.9 mg/L. The length of hospital stay for AIU patients was significantly greater compared with controls.Conclusion: AIU in KD children is not related to gender or aspirin dose, and those with AIU have more severe inflammation at admission. Aspirin should be withdrawn for AIU management. Baseline NT-proBNP may serve as a valuable biomarker to predict AIU.Keywords: Kawasaki disease, aspirin, aspirin-induced urticaria, case-control study
format	article
author	Lin Y Li Y Ma J Li A Liu Y Shi L
author_facet	Lin Y Li Y Ma J Li A Liu Y Shi L
author_sort	Lin Y
title	Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
title_short	Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
title_full	Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
title_fullStr	Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
title_full_unstemmed	Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study
title_sort	aspirin-induced delayed urticaria in children with kawasaki disease: a retrospective case-control study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/367dd47d401c489ca6d56498493a7187
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Aspirin-Induced Delayed Urticaria in Children with Kawasaki Disease: A Retrospective Case-Control Study

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