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Deterioration of cutaneous microcirculatory status of Kawasaki disease

Ming-Yii Huang1, Joh-Jong Huang, Teh-Yang Huang

  • 1Department of Radiation Oncology, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung 807, Taiwan.

Clinical Rheumatology
|February 8, 2012
PubMed

Insights

Kawasaki disease (KD) patients show abnormal microcirculation, particularly in the afebrile phase. This microcirculatory change correlates with coronary artery diameter, suggesting dynamic capillaroscopy as a valuable noninvasive assessment tool.

Area of Science:

  • Pediatric Rheumatology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Kawasaki disease (KD) is a critical pediatric illness causing systemic vasculitis, often affecting coronary arteries.
  • Coronary artery aneurysms and ectasia are significant complications of KD, necessitating early detection and monitoring.
  • Noninvasive assessment of microcirculation could offer insights into KD pathophysiology and progression.

Purpose of the Study:

  • To noninvasively evaluate cutaneous microcirculation in children with Kawasaki disease.
  • To correlate microcirculatory parameters with coronary artery diameter in KD patients.
  • To explore the utility of dynamic capillaroscopy in assessing KD-related microvascular changes.

Main Methods:

  • Laser Doppler flowmetry and dynamic capillaroscopy were used to assess nailbed microcirculation.
  • Evaluations were conducted in children with KD during afebrile and convalescent phases, compared to healthy controls.
  • 100 subjects were analyzed: 64 KD patients and 36 controls.

Main Results:

  • Kawasaki disease patients exhibited abnormal capillary morphology compared to controls, including wider arterial/venous limbs and reduced capillary loops.
  • A significant decrease in capillary blood cell velocity was observed during the afebrile phase of KD.
  • Decreased capillary blood cell velocity in the afebrile phase correlated significantly with increased coronary artery diameter.

Conclusions:

  • Kawasaki disease patients display persistent microcirculatory morphological alterations.
  • Microcirculation abnormalities, assessed via dynamic capillaroscopy, are present in both afebrile and convalescent KD phases.
  • Dynamic capillaroscopy shows promise as a noninvasive method for surveying microcirculation abnormalities in Kawasaki disease.

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