Coronary artery dimensions may be misclassified as normal in Kawasaki disease☆,☆☆,★,★★,♢
Section snippets
Subjects
Subjects were children who met criteria for Kawasaki disease4; were evaluated at Children’s Hospital, Boston, between December 1989 and March 1994; and had normal coronary arteries, as determined by Japanese Ministry of Health criteria, on all of their echocardiograms. A comparison group was comprised of children of comparable age (range, 0.5 to 14.6 years) who had been referred to the noninvasive laboratory at Boston Children’s Hospital for echocardiographic evaluation during the years 1987 to
Demographic Data
Subjects were 125 patients with Kawasaki disease who had no coronary abnormalities, as determined by Japanese Ministry of Health criteria, on any echocardiogram. Their median age at the onset of illness was 2.9 years (range, 0.3 to 11.2 years), and 70 (56%) were male. The majority of children (87, 70%) were white; 24 (19%) were black; 6 (5%) were Hispanic; 5 (4%) were Asian; and 3 (2%) were of mixed or other racial groups. A single infusion (2 g/kg) of intravenous gamma globulin was
Discussion
Recent guidelines of the American Heart Association3 suggest that patients with Kawasaki disease who have no coronary artery abnormalities at any stage of illness may be discharged from cardiac follow-up at 1 year after onset of illness. Of note, the guidelines do not specify criteria for abnormality. Coronary artery dimensions have been shown to increase linearly with indices of body size, such as BSA or body length.2 However, the most widely used criteria for coronary artery abnormality in
Acknowledgements
We thank Kathleen M. O’Brien for manuscript preparation.
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From the Departments of Cardiology and Medicine, Children’s Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
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Dr. de Zorzi is currently affiliated with the Department of Cardiology, Ospedale Bambino Gesu, Rome, Italy.
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Supported in part by the Kobren Fund.
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Reprint requests: Jane W. Newburger, MD, Department of Cardiology, Children’s Hospital, 300 Longwood Ave, Boston, MA 02115.
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0022-3476/98/$5.00 + 0 9/21/91490