Coronary diameter in normal infants, children and patients with Kawasaki disease.
BACKGROUND
The coronary assessments in Kawasaki disease are mainly based on the Japanese Ministry of Health and Welfare criteria, which is simply classified according to the patient's age, over 5 years and less than 4-years-old.


METHODS
We obtained normal values of coronary diameters adjusted for the body surface area and for the coronary anatomical site from 71 healthy children using 2-D echocardiography. We also studied patients with Kawasaki disease at three stages from the onset of illness: (i) 43 patients at admission; (ii) the subsequent 2-3 weeks; and (iii) 62 children followed at a clinic, for a median 2.2 years after the onset. No patients showed any coronary abnormalities by several echographic exams.


RESULTS
The coronary diameters were strongly correlated with the body surface area (r = 0.81 in left main, r = 0.89 in proximal right, r = 0.89 in left anterior descending artery). The coronary diameters in the patient groups at admission and at 2-3 weeks later were significantly larger than those in the normal group (P < 0.01). Although the coronary diameters in the follow-up group did not show a significant difference compared with those of normal, 19% retained their coronary diameters at greater than two standard deviations above the expected mean in at least one coronary artery.


CONCLUSIONS
The more strictly defined criteria adjusted for body size and for the anatomical site should be used to detect the subtle changes and to prevent the misclassification of the coronary artery abnormalities in KD.
Kurotobi
Shunji
S
Department of Pediatrics,Toyonaka Municipal Hospital, Shibahara-cho, 4-14-1, Toyonaka city, Osaka, Japan. kurotobi@ohp.toyonaka.osaka.jp
Nagai
Toshisaburo
T
Kawakami
Nobuhiro
N
Sano
Tetsuya
T
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology*; D011446:Prospective Studies; D012016:Reference Values