The widespread use of different methods for the determination of HDL-cholesterol (in Europe: sodium phosphotungstic acid/MgCl2) in connection with enzymatic procedures (in the USA: heparin/MnCl2 followed by the Liebermann-Burchard method) but common reference values makes it necessary to evaluate not only accuracy, specificity, and precision of the precipitation step but also of the subsequent cholesterol determination. A high ratio of serum vs. concentrated precipitation reagent (10:1 V/V) leads to the formation of variable amounts of delta-3.5-cholestadiene. This substance is not recognized by cholesterol oxidase but leads to an 1.6 times overestimation by the Liebermann-Burchard method. Therefore, errors in HDL-cholesterol determination should be considered and differences up to 30% may occur between HDL-cholesterol values determined by the different techniques (heparin/MnCl2 - Liebermann-Burchard and NaPW/MgCl2-CHOD-PAP).
In a 2-year 4-month-old boy endarteritic changes and spindle-shaped aneurysmas of the coronary arteries were found as a complication of Kawasaki syndrome. The vascular alteration, probably immunopathologically based, must be differentiated as a primary endarteritic process from primary necrotising periateritis nodosa which also occurs in childhood. The fate of the affected children is determined by the complications of coronary artery changes which however occur only in 1--2% of affected persons.
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