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Follow-Up Method in Patients with Kawasaki Disease who had No Coronary Artery Abnormalities in the Convalescent Period

Korean Journal of Pediatrics 2005;48(2):165-173.
Published online February 15, 2005.
Follow-Up Method in Patients with Kawasaki Disease who had No Coronary Artery Abnormalities in the Convalescent Period
Hee Jung Joo, Min Seob Song, Chul Ho Kim
Department of Pediatrics, Pusan Paik Hospital, College of Medicine, Inje University, Busan, Korea
회복기 심초음파 검사상 관상동맥 내경 크기가 정상 범위인 가와사끼병 환자에서 추적관찰 방법에 대한 고찰
주희정, 송민섭, 김철호
인제대학교 의과대학 부산백병원 소아과
Correspondence: 
Min Seob Song, Email: msped@inje.ac.kr
Abstract
Purpose
: We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal.
Methods
: Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey.
Results
: 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients.
Conclusion
: All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.
Key Words: Kawasaki disease , Coronary artery , Echocardiography , Follow-up studies


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