Endogenous cysteinyl leukotriene synthesis was assessed in 10 patients with Kawasaki disease and 10 healthy controls by measuring excretion of leukotriene E4 (LTE4) in urine. LTE4 was increased more than fivefold in patients with Kawasaki disease compared with controls (median (range) 55.3 (31.8-120.6) v 10.2 (7.1-14.9) nmol/mol creatinine); this suggests that cysteinyl leukotrienes are involved in the pathophysiology of Kawasaki disease. Leukotriene synthetase inhibition or receptor antagonism may therefore offer a new potential therapeutic approach in children with this disease.
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