Asymmetric and symmetric dimethylarginine are associated with coronary artery lesions in Kawasaki disease

Objective To determine whether 3 biomarkers, L-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA), can predict outcomes in patients with Kawasaki disease (KD). Study design Plasma levels of L-arginine, ADMA, and SDMA were measured in 39 patients with KD and 27 febrile control patients. Results Plasma L-arginine, ADMA, and SDMA levels were lower in patients with KD than in control patients before treatment with intravenous immunoglobulin (IVIG; P =.027, P <.001, and P <.001, respectively). After treatment with IVIG, L-arginine, ADMA, L-arginine/ADMA ratios, and arginine methylation ([ADMA + SDMA]/L-arginine) increased significantly (P <.001, P =.001, P =.014, and P =.001, respectively). Compared with control patients, persistent lower SDMA and higher ADMA/SDMA ratios existed in patients with KD. Furthermore, a lesser magnitude of change in terms of L-arginine and ADMA/SDMA ratios after IVIG treatment was associated with the formation of coronary dilation (P =.025, and.029, respectively). Conclusion Levels of L-arginine, ADMA, and SDMA appear to be associated with KD. Lower L-arginine levels and ADMA/SDMA after treatment with IVIG was associated with coronary artery abnormalities patients with KD.