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Chest X-ray Findings and Serum Tumor Necrosis Factor-α Levels in Patients with Kawasaki Disease

Korean Journal of Pediatrics 2005;48(5):534-538.
Published online May 15, 2005.
Chest X-ray Findings and Serum Tumor Necrosis Factor-α Levels in Patients with Kawasaki Disease
Ji Young Kim1, Jung Hyun Kwon1, Kyung Hyo Kim1, Jung Hyun Yu2, Young Mi Hong1
1Department of Pediatrics , College of Medicine, Ewha Womans University, Seoul, Kore
2Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Kore
가와사끼병 환아에서 흉부 X-선 검사의 변화와 혈중 Tumor Necrosis Factor-α에 대한 연구
김지영1, 권정현1, 김경효1, 유정현2, 홍영미1
1이화여자대학교 의과대학 동대문병원 소아과
2이화여자대학교 의과대학 동대문병원 방사선과
Correspondence: 
Young Mi Hong, Email: hongym@chollian.net
Abstract
Purpose
: Kawasaki disease(KD) is a multisystemic inflammatory vasculitis of unknown etiology. Many complications other than cardiovascular involvement have been recognized in KD. However, there have been few reports published concerning involvement of the lungs in this disease. The purpose of this study was to examine the relationship between serum TNF-α, the degree of coronary artery dilatation and chest X-ray(CXR) findings. In addition, we have investigated serum anti-Mycoplasma antibody(AMA) titers in patients with KD who have abnormal CXR findings.
Methods
: Eighty four patients with KD were included in this study(group I; 41 patients with normal CXR fndings, group II; 43 patients with abnormal CXR findings). Serum levels of TNF-α and AMA titer were measured.
Results
: We reviewed the CXR findings and clinical courses of 84 patients with Kawasaki disease and found abnormal CXR findings in 43 patients(51.2 percent). Peribronchial cuffing was the most frequent abnormality(22.4 percent). In the group with abnormal CXR findings(group II), a statistical difference was not noted in age, sex, duration of fever, hemoglobin, WBC, platelet, ESR, and CRP levels and incidence of coronary arterial lesions as compared with the group having normal CXR findings(group I). No difference was noted in serum TNF-α level between group I and group II. 2 patients(12.5 percent) of 16 KD patients with abnormal CXR findings have positive AMA titer(above 1 : 320).
Conclusion
: Most of the abnormal CXR findings in KD patients were peribronchial cuffing. The abnormal CXR findings in KD patients did not mean severe inflammations. It is difficult to consider that CXR abnormalities are related to coronary arterial lesions. In addition, further study on the relationship between Mycoplasma infection and Kawasaki disease is needed.
Key Words: Kawasaki disease , Chest X-ray , Cytokines


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