All issues > Volume 44(1); 2001

Original Article

J Korean Pediatr Soc. 2001;44(1):46-53. Published online January 15, 2001.

Influence of Epstein-Barr Virus Infection on Outcome of Coronary Artery Lesions in Patients with Kawasaki Disease

Hye-Yung HY Ahn¹, Hyang-Sook HS Kim², Jo-Won JW Jung¹, Ki-Soo KS Pai¹

¹Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
²Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea

Correspondence Jo-Won JW Jung ,Email: jwjung@madang.ajou.ac.kr

Abstract

Purpose
: Kawasaki disease(KD) may be linked to primary infection by certain common viruses. KD concurrent with Epstein-Barr virus(EBV) suggests the possibility of an etiologic agent related to the KD rather than to the EBV infection itself, but, the influence on coronary complication is unclear. To establish whether infection with EBV contributed to the outcome of coronary artery lesions in patients with KD is the purpose of this study.
Methods
: Retrospective studies were performed on 96 cases(age 2.48¡¾1.94 years) of KD evaluated with serologic studies of EBV(EBV EA IgM, EBV EA IgG, EBNA IgG) at admission. We evaluated the clinical features and coronary outcome between a control group with KD and an EBV associated group with KD.
Results
: On serologic studies of EBV, 62 patients(64.6%) with one more than positive results were in the EBV associated group with KD, in 30 patients with recent EBV infection, and in 32 patients with previous EBV infection. There were no significant differences between the control group and the EBV associated group in age, sex, and other clinical findings. Eighten patients (18.7%) had abnormal baseline echocardiogram, 13 patients(21.0%) among them were in the EBV associated group and 5 patients(14.7%) were in the control group; there was no significant difference between the two groups. Significantly 11 of 13 patients(84.6%) with coronary lesions had positive result of EBNA IgG, suggesting previous infection. There were no significant differences in retreatment and recurrence incidence. After retreatment, in 3 of 6 cases with the EBV associated group, and in no cases with the control group, cardiac complications were observed.
Conclusion
: Previous or chronic EBV infection may influence the occurrence of coronary lesion in patients with KD, even though patients with cardiac complication improved later.

Keywords :Kawasaki disease, Epstein-Barr virus, Coronary lesion