Labeled WBC cardiac imaging and two-dimensional echocardiography to evaluate high-dose gamma globulin treatment in Kawasaki disease.
Twenty-eight children (5 girls, 23 boys; age, 20.3 +/- 16.2 months) with Kawasaki disease (KD) were included in this study. The children were treated with aspirin plus intravenous injection of gamma globulin (IVGG). Both Tc-99m HMPAO labeled WBC heart imaging (Tc-WBC) and two-dimensional echocardiograms (2D-Echo) were used to evaluate the effects of IVGG on the most common cardiac presentations--carditis and dilated coronary arteries--in KD. After IVGG therapy, the results showed that 32.1% (9/28) carditis patients had improved; 39.3% (11/28) of patients had no significant change; 28.6% (8/28) of patients had severe changes, and there was no significant difference among the three groups by the evidences of Tc-WBC. Dilated coronary arteries (CA) became smaller in 32.1% (9/28) of patients; 53.6% (15/28) of patients had no definite change; 14.3% (4/28) of patients had dilated LCA that became larger; and borderline difference existed among the three groups, proved by 2D-Echo. Between the Tc-WBC and 2D-Echo, 35.7% (10/28) of patients had similar changes, and 64% (18/28) of patients showed incongruous changes; and there was little difference. In conclusion, Tc-WBC and 2D-Echo provide strong evidence of the existence of carditis and dilated coronary arteries in certain patients, even after IVGG treatment. The improvements of carditis and dilated coronary arteries were not correlated with each other after IVGG therapy.
Kao
C H
CH
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Hsieh
K S
KS
Chen
Y C
YC
Wang
Y L
YL
Wang
S J
SJ
Yeh
S H
SH
D001241:Aspirin / Q000627:therapeutic use; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007962:Leukocytes; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D015609:Organotechnetium Compounds; D010091:Oximes; D011877:Radionuclide Imaging; D019690:Technetium Tc 99m Exametazime
D016756:Immunoglobulins, Intravenous; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D001241:Aspirin