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The Study of Serum Troponin I and CK-MB in the Acute Stage of Kawasaki Disease

Journal of the Korean Pediatric Society 1998;41(5):695-700.
Published online May 15, 1998.
The Study of Serum Troponin I and CK-MB in the Acute Stage of Kawasaki Disease
Minshik Kim1, Yoonae Chun1, Youngok Lee1, Namji Cho1, Kyungsook Kim2
1Department of Pediatrics, Anyang Joongang General Hospital, Anyang, Korea
2Department of Clinicopathology, Anyang Joongang General Hospital, Anyang, Korea
급성기 가와사끼병 환아의 혈청 Troponin I와 CK-MB에 대한 연구
김민식1, 전윤애1, 이영옥1, 조남지1, 김경숙2
1안양중앙병원 소아과
2안양중앙병원 임상병리과
Correspondence: 
Minshik Kim, Email: 1
Abstract
Purpose
: The pathogensis and etiologic agents are still unknown but clinical studies suggest that Kawasaki disease(KD) is an autoimmune disease caused by infectious agents associated with the early development of acute myocarditis and coronary artery abnormalities. The study investigates serum troponin I(cTnI) and creatine kinase(CK)-MB in the acute stage of KD before diagnosis the use of intravenous immunoglobulin(IVIG) treatment to confirm and find early diagnosis of acute myocarditis.
Methods
: The patient group consisted of 36 cases of KD in the acute stage before IVIG treatment, and the control group consisted of 10 cases who didn't suffer from KD. The obtained sera was measured by using the Chemiluminoimmunoassay method, and compared with the results of both groups.
Results
: The sex ratio of male to female was 1.5 : 1, and the male age was 2.6¡¾1.6 years old. The level of cTnI increased in 14 cases(31.9%), and CK-MB increased in 9 cases(25%). Five cases(13.9%) in the patient group increased in both cTnI and CK-MB levels which correlated with each other significantly(P<0.05). But the levels of cTnI and CK-MB were negative in the control group. Acute phase reactants such as CRP, C3, ESR were positive and WBC increased in the acute stage of both groups.
Conclusion
: The level of cTnI correlates accurately to myocardial cell injury, so increasing the level of cTnI in the acute stage of KD is recommended for acute myocarditis or myocardial cell injure in the early stage before onset of clinical symptoms and signs. Therefore, the measurement of cTnI can be a more useful method for early diagnosis and confirmation of acute myocarditis than a CK-MB test, and may help in the early treatment of IVIG by reducing cardiovascular abnormalities in KD.
Key Words: Serum troponin I, Myocarditis, Kawasaki disease


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