Long-term consequences of Kawasaki disease among first-year junior high school students.

OBJECTIVE: To determine whether height, weight, and electrocardiographic (ECG) abnormalities differ at the age of 13 years between adolescents with and without Kawasaki disease (KD) (also known as mucocutaneous lymph node syndrome). DESIGN: A population-based cohort study. SETTING: School community and public health service. METHODS: Data from the nationwide surveys of KD in Japan were linked with those of junior high school cardiac screening in Tochigi Prefecture between April 1, 1986, and June 30, 1998 (except data for 1988 and 1994). Using this database, students with KD and students without KD in the first year of junior high school were compared. MAIN OUTCOME MEASURES: Height, weight, and ECG abnormalities. RESULTS: Eight hundred sixty students (486 adolescent boys and 374 adolescent girls) with KD and 308 729 students (158 193 adolescent boys and 150 536 adolescent girls) without KD were located. There was no difference in average height and weight between the students with and without KD (using the P values for a t test of the means). The proportion of abnormal ECG findings was 10% and 3% among those with and without KD, respectively. CONCLUSION: Even at age 13 years, the proportion of abnormal ECG findings was about 3 times higher among adolescents with KD (using a chi(2) test of the difference in 2 binomial proportions).

Secondary extramedullary plasmacytoma involving the pancreas.

Extramedullary plasmacytoma is a rare variant of plasma cell tumor involving organs outside the bone marrow. The vast majority of extramedullary plasmacytomas present as a secondary tumor of systemic myelomatosis of the bone marrow. We experienced a patient with extramedullary plasmacytomas of the head and tail of the pancreas presenting as secondary masses from extramedullary plasmacytoma of the maxillary sinus that had been treated 5 years previously. A 38-year-old Japanese man had undergone radiation therapy for an extramedullary plasmacytoma of the maxillary sinus 5 years before the current presentation. He experienced severe upper abdominal pain in November 1999, when laboratory data showed elevation of the serum amylase level. Computed tomography showed two isodensity masses, in the head and tail of the pancreas. Angiography showed two hypervascular masses, one in the head and the other in the tail of the pancreas, and encasement of the portal vein trunk junction. Laparotomy was performed, with the tentative diagnosis of extramedullary plasmacytoma of the pancreas, in order to obtain a definite diagnosis. Intraoperative biopsy revealed that the two pancreatic masses were extramedullary plasmacytomas. External radiation therapy was performed after the operation. When a pancreatic mass is noticed in patients with a history of plasmacytoma, secondary extramedullary plasmacytoma of the pancreas should be considered as a differential diagnosis.