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Association between Kawasaki disease and acute respiratory viral infections

Korean Journal of Pediatrics 2009;52(11):1241-1248.
Published online November 15, 2009.
Association between Kawasaki disease and acute respiratory viral infections
Eun Young Cho1, Byung Wook Eun2, Nam Hee Kim3, Jina Lee1, Eun Hwa Choi1, Hoan Jong Lee1, Jung Yun Choi1
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
2Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, Korea,
3Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
가와사끼병과 급성 호흡기 바이러스 감염증의 연관성에 관한 연구
조은영1, 은병욱2, 김남희3, 이진아1, 최은화1, 이환종1, 최정연1
1서울대학교 의과대학 소아과학교실
2가천의과대학교 의학전문대학원 소아과학교실
3인제대학교 의과대학 소아과학교실
Eun Hwa Choi, Email: eunchoi@snu.ac.kr
: The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections.
: Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children’s Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively.
: The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P> 0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05).
: Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.
Key Words: Kawasaki disease, Respiratory tract infections, Human coronavirus

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