Background: Kawasaki disease (KD) is an acute febrile illness characterized by systemic vasculitis of unknown etiology. Recent studies have shown that even after resolution of the disease, endothelial dysfunction persists and may progress to premature atherosclerosis. Carotid intima-media thickness (cIMT) is a well-established indicator for atherosclerosis in both pediatric an adult patients.
Objective: To assess whether patients after Kawasaki disease (KD) have increased risk factors and abnormalities suggestive of premature atherosclerosis by measuring the cIMT compared with healthy control subjects.
Material and Methods: One hundred and three patients with KD aged 102.12 ± 41.82 months (61.94 ± 33.23 after the acute episode) and 83 age-matched healthy control subjects were examined for family, medical and dietary history, serum markers of atherosclerotic risk and inflammation and carotid intimal-medial thickness (CIMT) with vascular ultrasound scanning.
Results: Patients and control subjects were similar in age, gender, family and dietary history, body mass index and blood pressure. We found no difference in the levels of triglycerides and glucose. And the levels of total cholesterol (162 ± 39.2 vs 150 ± 37.4), low-density lipoprotein cholesterol (102.57 ± 32.3 vs 89.6 ± 33.5), and high-density lipoprotein cholesterol (47.38 ± 17.65 vs 39.5 ± 17.54) were slightly higher with no statistical significance. The cIMT was slightly higher in the KD group (0.48 ± 0.1 vs 0.45 ± 0.15) We did found higher levels in the lipid profile and in the cIMT in children with or with regression of coronary aneurysms compared with children without coronary aneurysms.
Conclusions: There is no clear evidence of increased atherosclerosis in Mexican children with KD, but there is evidence of an altered lipid profile and in the cIMT in patients with KD with coronary lesions compared with children with KD without coronary lesions the warrant further study