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http://dx.doi.org/10.3339/jkspn.2013.17.2.86

Renal Manifestations and Imaging Studies of Kawasaki Disease  

Oh, Ji Young (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine)
Park, Se Jin (Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine)
Kim, Sun Jung (Department of Nuclear Medicine, National Health Insurance Corporation Ilsan Hospital)
Jang, Gwang-Cheon (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital)
Kim, Uria (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital)
Shin, Jae Il (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine)
Kim, Kee Hyuck (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital)
Publication Information
Childhood Kidney Diseases / v.17, no.2, 2013 , pp. 86-91 More about this Journal
Abstract
Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.
Keywords
Kawasaki disease; Renal complication; Single photon emission computed tomography together with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA); ${\beta}_2$-microglobulin;
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1 Burgner D, Harnden A. Kawasaki disease: what is the epidemiology telling us about the etiology? Int J Infect Dis 2005;9:185-94.   DOI
2 Yim D, Curtis N, Cheung M, Burgner D. An update on Kawasaki disease II: Clinical features, diagnosis, treatment and outcomes. J Paediatr Child Health 2013;49:614-23.   DOI
3 Royle J, Burgner D, Curtis N. The diagnosis and management of Kawasaki disease. J Paediatr Child Health 2005;41:87-93.   DOI
4 Kim DS. Kawasaki disease. Yonsei Med J 2006;47:759-72.   DOI
5 Ogata S, Tremoulet AH, Sato Y, Ueda K, Shimizu C, Sun X, et al. Coronary artery outcomes among children with Kawasaki disease in the United States and Japan. Int J Cardiol 2013.
6 Gordon JB, Kahn AM, Burns JC. When children with Kawasaki disease grow up: Myocardial and vascular complications in adulthood. J Am Coll Cardiol 2009;54:1911-20.   DOI
7 Choi JY, Park SY, Choi KH, Park YH, Lee YH. Clinical characteristics of Kawasaki disease with sterile pyuria. Korean J Pediatr 2013;56:13-8.   DOI
8 Shike H, Kanegaye JT, Best BM, Pancheri J, Burns JC. Pyuria associated with acute Kawasaki disease and fever from other causes. Pediatr Infect Dis J 2009;28:440-3.   DOI
9 Melish ME, Hicks RM, Larson EJ. Mucocutaneous lymph node syndrome in the United States. Am J Dis Child 1976;130:599-607.
10 Bonany PJ, Bilkis MD, Gallo G, Lago N, Dennehy MV, Sosa del Valle JM, et al. Acute renal failure in typical Kawasaki disease. Pediatr Nephrol 2002;17:329-31.   DOI
11 Salcedo JR, Greenberg L, Kapur S. Renal histology of mucocutaneous lymph node syndrome (Kawasaki disease). Clin Nephrol 1988;29:47-51.
12 Wang JN, Chiou YY, Chiu NT, Chen MJ, Lee BF, Wu JM. Renal scarring sequelae in childhood Kawasaki disease. Pediatr Nephrol 2007;22:684-9.   DOI
13 Senzaki H, Suda M, Noma S, Kawaguchi H, Sakakihara Y, Hishi T. Acute heart failure and acute renal failure in Kawasaki disease. Acta Paediatr Jpn 1994;36:443-7.   DOI
14 Veiga PA, Pieroni D, Baier W, Feld LG. Association of Kawasaki disease and interstitial nephritis. Pediatr Nephrol 1992;6:421-3.   DOI
15 Ferriero DM, Wolfsdorf JI. Hemolytic uremic syndrome associated with Kawasaki disease. Pediatrics 1981;68:405-6.
16 Heldrich FJ, Jodorkovsky RA, Lake AM, Parnes CA. Kawasaki syndrome: HUS and HSP complicating its course and management. Md Med J 1987;36:764-6.
17 Mac Ardle BM, Chambers TL, Weller SD, Tribe CR. Acute renal failure in Kawasaki disease. J R Soc Med 1983;76:615-6.   DOI
18 Watanabe T, Abe Y, Sato S, Uehara Y, Ikeno K, Abe T. Sterile pyuria in patients with Kawasaki disease originates from both the urethra and the kidney. Pediatr Nephrol 2007;22:987-91.   DOI
19 Berggard I, Bearn AG. Isolation and properties of a low molecular weight beta-2-globulin occurring in human biological fluids. J Biol Chem 1968;243:4095-103.
20 Kil HR. Kawasaki disease and hyponatremia. Korean Circ J 2010;40:489-90.   DOI
21 Gowda S, Desai PB, Kulkarni SS, Hull VV, Math AA, Vernekar SN. Markers of renal function tests. N Am J Med Sci 2010;2: 170-3.
22 Lim GW, Lee M, Kim HS, Hong YM, Sohn S. Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion in kawasaki disease. Korean Circ J 2010;40:507-13.   DOI
23 Watanabe T, Abe Y, Sato S, Uehara Y, Ikeno K, Abe T. Hyponatremia in Kawasaki disease. Pediatr Nephrol 2006;21:778-81.   DOI
24 Nardi PM, Haller JO, Friedman AP, Slovis TL, Schaffer RM. Renal manifestations of Kawasaki's disease. Pediatr Radiol 1985;15:116-8.   DOI