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The Relationship between Human Neutrophil Elastase and Coronary Arterial Dilatation in Kawasaki Disease

Journal of the Korean Pediatric Society 2003;46(9):903-908.
Published online September 15, 2003.
The Relationship between Human Neutrophil Elastase and Coronary Arterial Dilatation in Kawasaki Disease
Jun Yong Shim1, Hee Won Choi1, Ja Hyun Hong2, Jong Kyun Lee2, Hae Yong Lee1
1Department of Pediatrics, Wonju College of Medicine, Yonsei University, Wonju, Korea
2Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
가와사끼병 환아에서의 혈장 및 호중구의 Elastase 활성도와 관상동맥 증대와의 관계
심준용1, 최희원1, 홍자현2, 이종균2, 이해용1
1연세대학교 원주의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
Correspondence: 
Hae Yong Lee, Email: leehy@wonju.yonsei.ac.kr
Abstract
Purpose
: Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis.
Methods
: Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured.
Results
: The significant increased plasma elastase activity, 6.19?.74 U/mL, found in Kawasaki disease patients compared with the other febrile disease patients, 4.86?.17 U/mL(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant.
Conclusion
: Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.
Key Words: Kawasaki disease, Coronary arterial dilatation, Human Neutrophil Elastase


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