ABC | Volume 113, Nº6, December 2019

Original Article Reyna et al Coronary dilation in exanthematous illness Arq Bras Cardiol. 2019; 113(6):1114-1118 Table 3 – Comparison of Z scores of coronary arteries between subjects with febrile exanthematous illness and subjects with Kawasaki disease FEI (mean(IC 95%) KD p PRCA 0.45 (–0.01–0.9) 0.2 0.05 MDCA –0.004 (–0.3–0.3) 4.8 0.05 DRCA –0.2(–0.8–0.3) 2.3 0.05 LMCA 0.13 (–0.2–0.5) 0.6 0.05 Circumflex –0.01(–0.4–0.4) 0.6 0.05 LAD –0.36 (–0.01–0.5) 0.5 0.05 PRCA: Proximal Right Coronary Artery; MRCA: Medial Right Coronary Artery; DRCA: Distal Right coronary artery; LMCA: Left main coronary artery; LAD: left anterior descending coronary artery. Conclusions In this study, we found an important percentage of patients diagnosed with FEI with an alteration in the dimension of the coronary arteries. This makes us conclude that coronary changes acquired in childhood are not exclusive to KD and should be carefully considered when establishing a diagnosis. Although the pathophysiological mechanisms underlying coronary changes in FEIs are not clear, it has been observed that they can cause temporary or permanent coronary damage. Author contributions Conception and design of the research: Reyna J, Limón AE; Acquisition of data: Reyna J, Reyes LM, Reyes L, Campos FH, Meza P, Lagunas A, Contreras C; Analysis and interpretation of the data: Reyna J, Reyes L, Meza P, Contreras C, Limón AE; Statistical analysis: Reyna J; Writing of the manuscript: Reyna J, Reyes LM, Campos FH, Meza P, Lagunas A, Contreras C, Limón AE; Critical revision of the manuscript for intellectual content: Reyna J, Reyes LM, Reyes L, Campos FH, Lagunas A, Limón AE. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of master submitted by Luz Marina Reyes, from National University from Mexico. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Hospital Central Sur de Alta Especialidad under the protocol number 39/17. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Kang JH. Febrile illness with skin rashes. Infect Chemother. 2015;47:155-66. 2. Trevisan A, Morandin M, Frasson C, Paruzzolo P, Davanzo E, Marco LD, et al. Prevalence of childhood exanthematic disease antibodies in paramedical students: need of vaccination. Vaccine. 2006;24(2):171-6. 3. Kil HR, Yu JW, Lee SC, Rhim JW, Lee KY. Changes in clinical and laboratory features of Kawasaki disease noted over time in Daejeon, Korea. Pediatr Rheumatol Online J. 2017;15(1):60. 4. Frieden IJ1, Resnick SD Childhood exanthems. Old and new. Pediatr Clin North Am. 1991;38(4):859-87. 5. Ghelani, SJ, Sable, C, Wiedermann, BL, Spurney CF. Increased incidence of incomplete Kawasaki disease at a pediatric hospital after publication of the 2004 American Heart Association guidelines. Pediatric Cardiol. 2012;33(7):1097-103. 6. PucciA,MartinoS,TibaldiM,BartoloniG. IncompleteandatypicalKawasaki disease: a clinicopathologic paradox at high risk of sudden and unexpected infant death. Pediatr Cardiol. 2012;33(5):802-5. 7. Kim JH, Kang HR, Kim SY, Ban JE. Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection. Korean J Pediatr. 2018;61(2):43-8. 8. Capittini C, Emmi G, Mannarino S, Bossi G, Dellepiane RM, Salice P, et al. An immune-molecular hypothesis supporting infectious aetiopathogenesis of Kawasaki disease in children. Eur J Immunol. 2018;48(3):543-5. 9. ElGuindy MS, ElGuindy AM. Aneurysmal coronary artery disease: an overview. Glob Cardiol Sci Pract. 2017;2017(3):e201726. 10. Pilania RK, Bhattarai D, Singh S. Controversies in diagnosis andmanagement of Kawasaki disease. World J Clin Pediatr. 2018;7(1):27-35. 11. Parameter (z)-EchoZ-ScoreCalculators [Internet]. [acessoem18Nov2017]. Disponível em: http://parameterz.blogspot.mx/2008/09/coronary-artery-z- scores.html 12. Muniz JC, Dummer K, Gauvreau K, Colan SD, Fulton DR, Newburger JW. Coronary artery dimensions in febrile children without Kawasaki disease. Circ Cardiovasc Imaging. 2013;6(2):239-44. References 1117