RESUMO
PURPOSE: The pathogensis and etiologic agents are still unknown but clinical studies suggest that Kawasaki disease (KD) is an autoimmune disease caused by infectious agents associated with the early development of acute myocarditis and coronary artery abnormalities. The study investigates serum troponin I (cTnI) and creatine kinase (CK)-MB in the acute stage of KD before diagnosis the use of intravenous immunoglobulin (IVIG) treatment to confirm and find early diagnosis of acute myocarditis. METHODS: The patient group consisted of 36 cases of KD in the acute stage before IVIG treatment, and the control group consisted of 10 cases who didn't suffer from KD. The obtained sera was measured by using the Chemiluminoimmunoassay method, and compared with the results of both groups. RESULTS: The sex ratio of male to female was 1.5 : 1, and the male age was 2.6 +/- 1.6 years old. The level of cTnI increased in 14 cases (31.9%), and CK-MB increased in 9 cases (25%). Five cases (13.9%) in the patient group increased in both cTnI and CK-MB levels which correlated with each other significantly (P<0.05). But the levels of cTnI and CK-MB were negative in the control group. Acute phase reactants such as CRP, C3, ESR were positive and WBC increased in the acute stage of both groups. CONCLUSION: The level of cTnI correlates accurately to myocardial cell injury, so increasing the level of cTnI in the acute stage of KD is recommended for acute myocarditis or myocardial cell injure in the early stage before onset of clinical symptoms and signs. Therefore, the measurement of cTnI can be a more useful method for early diagnosis and confirmation of acute myocarditis than a CK-MB test, and may help in the early treatment of IVIG by reducing cardiovascular abnormalities in KD.
