Abstract 4143723: Thrombocytosis is Prevalent and Associated with Greater Inflammation and Coronary Artery Involvement in Both Kawasaki Disease and Multisystem Inflammatory Syndrome in Children Associated with COVID-19
Bibliographic record
Abstract
Introduction: Thrombocytosis, sometimes extreme, after acute Kawasaki disease (KD) is common and felt to be pathognomonic of this diagnosis, although has also been reported after multisystem inflammatory syndrome in children (MIS-C), a clinically similar condition. We sought to determine differences in factors associated with thrombocytosis for each condition. Methods: From 01/2020 to 10/2023 across 41 sites in 8 countries from the International KD Registry, 1674 MIS-C and 1290 contemporaneous KD patients with adequate laboratory data were included in the analysis. Age-related cutpoints (derived from the CALIPER Study of normal children/adolescents; AJCP 2020; 154:342) were applied to peak platelet counts to define thrombocytosis (age <1 year, >647 x10 9 /L; age 1 to <12 years, >434; age 12 to <21 years, >371). Associations of demographic, clinical, laboratory and outcome factors with thrombocytosis were determined for each diagnosis group. Results: Thrombocytosis was more prevalent after KD (57%) than MIS-C (49%; p<0.001), with higher median peak platelet count (492 vs. 413 x10 9 /L; p<0.001). The difference remained significant after adjustment for age. Thrombocytosis was significantly associated with greater total days of fever for both KD (median 8 vs. 7 days; p=0.005) and MIS-C (median 7 vs. 6 days; p<0.001), but not with any symptoms/signs or presentation with shock in either group. For both groups, thrombocytosis was associated with significantly greater laboratory abnormalities, specifically higher markers of inflammation, lower hemoglobin and lower albumin. Cardiac biomarkers (peak NTproBNP, peak troponin I) were significantly lower for KD patients with thrombocytosis. While there was no significant association of thrombocytosis with ventricular function in either group (FIGURE A), coronary artery involvement was worse for both groups if thrombocytosis occurred (FIGURE B), with an overall lower prevalence and severity for patients with MIS-C, despite more severe clinical presentation and greater laboratory abnormalities. Conclusions: Thrombocytosis has a high prevalence for both KD and MIS-C, and is associated with both more severe inflammation and greater coronary artery involvement for both diagnoses.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".