Abstract 13271: Aortic Inflammation Continues in Patients With A History of Kawasaki Disease and Persistent Arterial Aneurysms

Abstract

Introduction: Kawasaki disease (KD) is well known vasculitis that primarily affects small to middle sized arteries such as coronary arteries and/or peripheral arteries. However, little evidence showed inflammation of large vasculature such as the aorta in patients with KD. Measurements of 18F-fluorodeoxyglucose (FDG) uptake evaluated by positron emission tomography (PET) and X-ray computed tomography (CT) could be useful to identify inflammatory activity of the vessel wall. Hypothesis: We hypothesized that aortic inflammation continues long after KD. Methods: FDG-PET/CT was performed in 19 patients with a history of KD. Of 19 patients, 11 patients still had persistent coronary and/or systemic vascular aneurysms (KD-An) and the remaining 8 revealed regression of arterial aneurysms (KD-Reg). Patients suffered from KD at 2.8 ± 3.2 years old and underwent FDG-PET at 22.2 ± 8.0 years old. FDG-PET was also performed in 5 control with age 14.1 ± 2.6 years old. Vascular inflammation was measured by blood-normalized standardized uptake value, known as a target-to-background ratio (TBR). Also demographic and laboratory data were collected. Results: Aortic FDG uptake was distinctly intense in patients with a history of KD and persistent vascular aneurysms. The Aortic TBR was significantly higher in KD-An (1.50 ± 0.30) than KD-Reg (1.11 ± 0.13, p = 0.004) or controls (1.03 ± 0.25, p=0.003). Although Control was significantly younger and had significantly lower body mass index, there was no significant correlation between these values and TBR. Also there was no significant difference in laboratory data including lipid profiles and glycemic status among 3 groups. Conclusions: Vascular inflammation of the aortic wall continues long after KD with persistent arterial aneurysms.