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Searching For The Cause Of Kawasaki Disease — Cytoplasmic Inclusion Bodies Provide New Insight

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608 The Study Of Late Arterial Lesion In Children With Coronary Aneurysm Due To Kawasaki Disease

Objectives: Concerns have been raised regarding the existence of endothelial damage and the possibility of a predisposition to premature atherosclerosis in young adulthood with a history of Kawasaki disease (KD). This study was designed to evaluate the endothelial function and carotid intima-media thickness in children with coronary aneurysms.

Methods: Thirty-one children with coronary aneurysms (9 with medium and 22 with giant aneurysms) due to KD and 21 healthy controls were enrolled. The duration from the onset of disease was 1-12.5 years (median 2.53 years) in KD group. Brachial artery flow-mediated dilation, non- flowmediated dilation, carotid artery stiffness index and intima-media thickness were determined by highfrequency ultrasound.

Results: One KD patient had angina pectris, another had heart failure and abnormal Q waves. Endothelial dependent flow-mediated dilation (FMD) and Non flow-mediated dilation was lower in patients with coronary aneurysms due to KD as compared with normal controls (P< 0.05). Arterial stiffness index was raised in KD group than in normal controls (P< 0.05). There was no difference between the two groups in carotid intima-media thickness. The FMD was lower in KD patients with myocardial ischemia or ECG abnormalities than in patients without (P< 0.05), while no difference was found in FMD between patients with giant aneurysms and those with medium aneurysms.

Conclusions: The endothelial function in patients with coronary aneurysms due to Kawasaki disease is damaged, especially in patients with giant coronary aneurysm and myocardial ischemia.


Kawasaki Disease: Know How To Spot Signs Of Serious Illness, Urges Mum

A POOLE mum is urging parents to be alert after her son developed a serious but little known illness.

Finley Green, 12, was taken to the doctors in August this year after developing a persistent fever, with aching limbs, red eyes and tongue and cracked lips.

The St Edward's School pupil was referred to hospital where consultants puzzled over the cause of his malady, even removing his appendix as they feared it might be infected. It took 10 days for them to correctly diagnose the autoimmune syndrome Kawasaki disease, now the commonest cause of acquired heart disease in the UK.

Finley's mother Nicky, 40, said the delay had led to complications as he developed aneurysms in his heart which are likely too large to fully heal.

Now she is urging parents to look out for the characteristic symptoms of the disease, which many people, if they know of it at all, wrongly believe to be restricted to very young children in the Far East.

"It is important to diagnose this as soon as possible," she said.

"Fin has a couple of medium sized aneurysms and one large one, but if his illness was identified sooner that might not be the case.

"The main things to look for are the temperature not falling, the red eyes and tongue, and the chapped lips. Fin didn't get peeling hands and feet but that is also common.

"If you see them call your doctor straight away."

Finley, who spent eight weeks in hospital, gets tired easily and has to regularly test his blood with a pinprick. He attends check ups where his condition is monitored by doctors.

"I'm not allowed to do sports as I am on warfarin, so I have to catch up on my maths instead," he said.

"I liked the sports curriculum and managed to get in the top class, but this has sucked the fun out of it."

The cause of Kawasaki disease is still unknown, but it is thought to be exposure to an unidentified airborne infectious agent. It was first identified in Japan in the 1960s, and is still most common there.

Professor Michael Levin of Imperial College London said the illness had been "neglected" by funding bodies in the UK.

"Neither the public nor the medical and scientific community have adequately appreciated that Kawasaki disease is now the commonest cause of acquired heart disease in children in the UK and other developed countries," he said.

"There is an urgent need for research to develop a diagnostic test for the disease, to identify the cause, and to evaluate new treatments."

Finley's family are also urging people to support a new charity, Kawasaki Disease Research, which was set up by professor Levine alongside professor Jane Burns of Rady Children's Hospital in San Diego. Every pound raised for the charity will be match funded by the Gordon and Marilyn Macklin Foundation.

Finley's sister Poppy, nine, has already made a start by persuading friends at her school's fundraising tuck shop to donate £160. Finley also went to Yarrells School, Upton, which has said it is proud them both.

To make a donation to the charity visit uk.Virginmoneygiving.Com/fund/KawasakiDiseaseResearch.






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