title: Coronary artery dilation among patients presenting with systemic-onset juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To evaluate coronary artery diameters among patients presenting with systemic-onset juvenile idiopathic arthritis (SoJIA).
  
  
  METHODS
  Fifty cases of SoJIA were reviewed. At the time of initial presentation with fever, 12 patients had echocardiograms that included a complete evaluation of the coronary arteries. A single reviewer measured the diameters of the left main, proximal left anterior descending, and proximal right coronary arteries. Body surface area-adjusted z scores were calculated with respect to a normative population.
  
  
  RESULTS
  Coronary artery dilation (z score: >2) was observed for 5 of the 12 patients with SoJIA who had echocardiograms performed at the time of presentation with fever. No patient developed a coronary artery aneurysm, and all of the coronary artery z scores normalized within 4 months. Only 2 of the 5 patients with coronary artery z scores of >2 fulfilled the clinical criteria for Kawasaki disease, the most commonly recognized cause of coronary artery dilation among children.
  
  
  CONCLUSIONS
  Children presenting with SoJIA may have coronary artery dilation similar to that observed for children with Kawasaki disease. These data suggest that the presence of coronary artery dilation on initial echocardiograms for patients with fever does not exclude the diagnosis of SoJIA.
authors.affiliation: Rheumatology Program, Division of Immunology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
authors.forename: Bryce A
authors.initials: BA
authors.lastname: Binstadt
authors.forename: Jami C
authors.initials: JC
authors.lastname: Levine
authors.forename: Peter A
authors.initials: PA
authors.lastname: Nigrovic
authors.forename: Kimberlee
authors.initials: K
authors.lastname: Gauvreau
authors.forename: Fatma
authors.initials: F
authors.lastname: Dedeoglu
authors.forename: Robert C
authors.initials: RC
authors.lastname: Fuhlbrigge
authors.forename: Steven N
authors.initials: SN
authors.lastname: Weindling
authors.forename: Jane W
authors.initials: JW
authors.lastname: Newburger
authors.forename: Robert P
authors.initials: RP
authors.lastname: Sundel
mesh_terms: D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic; D004452:Echocardiography; D005334:Fever; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis