Prediction of the risk of coronary arterial lesions in Kawasaki disease by serum 25-hydroxyvitamin D(3)

Kawasaki disease (KD) is associated with the development of coronary arterial lesions (CALs) in children. We aimed to test the hypothesis that circulating 25-hydroxyvitamin D(3) [25-(OH)D(3)] could be identified as a clinical parameter for predicting CALs secondary to KD in children. We enrolled 35 children with KD in the acute phase and measured serum 25-(OH)D(3) levels in all of them, then followed up by echocardiography for CALs. Additionally, serum 25-(OH)D(3) levels were obtained in 23 febrile children with respiratory tract infections and 30 healthy children. Of the 35 KD children, nine had CALs according to echocardiography and 26 did not (NCALs). Serum 25-(OH)D(3) levels were not significantly different between NCALs and healthy children (49.2 ± 23.8 versus 44.1 ± 30.2 ng/ml; P = 0.49). Serum 25-(OH)D(3) levels were significantly higher in children with CALs than those without CALs (83.9 ± 26.3 versus 49.2 ± 23.8 ng/ml; P = 0.001). The cutoff value of 65 ng/ml to predict subsequent CALs had a specificity of 0.73, sensitivity of 0.78, and diagnostic accuracy of 0.74. Conclusion: Serum 25-(OH)D(3) levels were elevated dur-ing the acute phase in KD children who had subsequent CALs. Serum 25-(OH)D(3) levels in the acute phase of KD may be used to predict subsequent CALs.