Coronary Artery Dilation in Children with Febrile Exanthematous Illness without Criteria for Kawasaki Disease

Abstract Background: Coronary dilatation is the most important complication of Kawasaki disease (KD) and, in addition to some clinical characteristics, is common to KD and febrile exanthematous illnesses (FEIs). Objective: To assess whether children with FEI, who do not meet the criteria for KD, have changes in coronary arteries dimensions. Methods: Echocardiography was performed within the first two weeks of the disease in patients < 10 years with fever and exanthema without other KD criteria. To make a comparison with KD patients, we reviewed the echocardiograms and medical records of patients with a diagnosis of KD of the last five years. Coronary ectasia was assessed using Z scores of coronary arteries. The means of the dimensions of the coronary arteries were compared with a z test and a level of significance of 0.05 was adopted. Results: A total of 34 patients were included, 22 (64.7%) with FEI, and 12(35.2%) with a diagnosis of KD. Using the Z scores of coronary artery, a dilation of any of the coronary artery branches was observed in six (27.2%) patients with FEI. Conclusions: An important percentage of patients with FEI has coronary artery dilation.

摘要 背景：冠状动脉扩张是川崎病（Kawasaki disease, KD）最关键的并发症；除部分临床特征外，该表现也可见于川崎病与发热伴皮疹性疾病（febrile exanthematous illnesses, FEIs）。
研究目的：评估不符合川崎病诊断标准的发热伴皮疹性疾病患儿，是否存在冠状动脉内径改变。
研究方法：对发病2周内完成超声心动图检查的10岁以下伴发热与皮疹、且不具备其余川崎病诊断标准的患儿展开研究。为与川崎病患者进行对照，本研究回顾了近5年确诊川崎病患者的超声心动图与病历资料。采用冠状动脉Z评分评估冠状动脉扩张情况，通过Z检验比较两组冠状动脉内径的均值，并设定显著性水平为0.05。
研究结果：本研究共纳入34例患儿，其中22例（64.7%）为发热伴皮疹性疾病患者，12例（35.2%）为川崎病确诊患者。通过冠状动脉Z评分评估发现，6例（27.2%）发热伴皮疹性疾病患儿存在至少一支冠状动脉分支扩张。
研究结论：存在相当比例的发热伴皮疹性疾病患儿可出现冠状动脉扩张。