URINARY NEOPTERIN AS A PREDICTIVE MARKER OF CORONARY-ARTERY ABNORMALITIES IN KAWASAKI SYNDROME

We investigated whether urinary neopterin concentrations respond to th e pathological conditions (especially coronary artery dilatation) of K awasaki syndrome. All of 29 children with Kawasaki syndrome had very h igh urinary neopterin concentrations. Increased urinary neopterin conc entrations coincided with fever and with monocytosis in peripheral blo od. The urinary neopterin excretion peaking within the first 8 days af ter onset correlated with the development of coronary artery dilatatio n. Increased urinary neopterin concentrations indicate that cell-media ted immunity is activated in patients with Kawasaki syndrome. Endogeno us interferon-gamma and activation of monocytes/macrophages may play a role in the pathogenesis of Kawasaki syndrome. Not only do neopterin concentrations correlate with symptoms in the acute phase of Kawasaki syndrome, they also act as a predictive marker of coronary artery abno rmalities in affected patients.