Acute pericardial effusion representing the tnf-α-mediated severe inflammation but not the coronary artery outcome of Kawasaki disease

S. Okada, S. Hasegawa, Y. Suzuki, T. Matsubara, M. Shimomura, M. Okuda, T. Ichiyama, S. Ohga

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To establish the optimal inflammation control of Kawasaki disease (KD), we investigated the clinical and pathophysiological basis of pericardial effusion (PE) during the acute phase of KD. Method: Clinical and laboratory features of Japanese KD children with PE (PE group: n = 9) and without PE (non-PE group: n = 89) were studied retrospectively by using the medical records. Serum levels of soluble tumour necrosis factor receptor 1 (sTNFR1), interleukin 6 (IL-6), and vascular endothelial growth factor (VEGF) were assessed by enzymelinked immunosorbent assays (ELISAs). Results: PE group patients had coronary artery lesions (CALs) more frequently than non-PE group patients during the acute phase of KD (33% vs. 5.6%, p = 0.024). PE patients also showed lower levels of haemoglobin (p < 0.01) and serum albumin (p < 0.01) and higher platelet counts (p=0.013) than non-PE patients. The proportion of neurological symptoms, but not other manifestations, in the PE group was higher than in the non-PE group (p = 0.022). All patients survived free from coronary artery aneurisms. Serum levels of sTNFR1, but not the other cytokines, in the PE group were higher than those in the non-PE group (p < 0.001). The sTNFR1 levels correlated positively with C-reactive protein (CRP) (r = 0.30, p = 0.019) or total bilirubin (r = 0.40, p < 0.01) levels. Conclusions: Acute PE in KD patients indicated the severity of TNF-mediated vascular inflammation and concurrent CALs. According to the progression, these patients might need more targeted therapy of anti-inflammation for a better coronary outcome.

Original languageEnglish
Pages (from-to)247-252
Number of pages6
JournalScandinavian Journal of Rheumatology
Volume44
Issue number3
DOIs
Publication statusPublished - May 1 2015
Externally publishedYes

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Mucocutaneous Lymph Node Syndrome
Pericardial Effusion
Coronary Vessels
Inflammation
Tumor Necrosis Factor Receptors
Immunosorbents
Serum
Platelet Count
Bilirubin
Serum Albumin
C-Reactive Protein
Vascular Endothelial Growth Factor A
Medical Records
Blood Vessels
Interleukin-6
Hemoglobins
Cytokines

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

Acute pericardial effusion representing the tnf-α-mediated severe inflammation but not the coronary artery outcome of Kawasaki disease. / Okada, S.; Hasegawa, S.; Suzuki, Y.; Matsubara, T.; Shimomura, M.; Okuda, M.; Ichiyama, T.; Ohga, S.

In: Scandinavian Journal of Rheumatology, Vol. 44, No. 3, 01.05.2015, p. 247-252.

Research output: Contribution to journalArticle

Okada, S. ; Hasegawa, S. ; Suzuki, Y. ; Matsubara, T. ; Shimomura, M. ; Okuda, M. ; Ichiyama, T. ; Ohga, S. / Acute pericardial effusion representing the tnf-α-mediated severe inflammation but not the coronary artery outcome of Kawasaki disease. In: Scandinavian Journal of Rheumatology. 2015 ; Vol. 44, No. 3. pp. 247-252.
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abstract = "Objectives: To establish the optimal inflammation control of Kawasaki disease (KD), we investigated the clinical and pathophysiological basis of pericardial effusion (PE) during the acute phase of KD. Method: Clinical and laboratory features of Japanese KD children with PE (PE group: n = 9) and without PE (non-PE group: n = 89) were studied retrospectively by using the medical records. Serum levels of soluble tumour necrosis factor receptor 1 (sTNFR1), interleukin 6 (IL-6), and vascular endothelial growth factor (VEGF) were assessed by enzymelinked immunosorbent assays (ELISAs). Results: PE group patients had coronary artery lesions (CALs) more frequently than non-PE group patients during the acute phase of KD (33{\%} vs. 5.6{\%}, p = 0.024). PE patients also showed lower levels of haemoglobin (p < 0.01) and serum albumin (p < 0.01) and higher platelet counts (p=0.013) than non-PE patients. The proportion of neurological symptoms, but not other manifestations, in the PE group was higher than in the non-PE group (p = 0.022). All patients survived free from coronary artery aneurisms. Serum levels of sTNFR1, but not the other cytokines, in the PE group were higher than those in the non-PE group (p < 0.001). The sTNFR1 levels correlated positively with C-reactive protein (CRP) (r = 0.30, p = 0.019) or total bilirubin (r = 0.40, p < 0.01) levels. Conclusions: Acute PE in KD patients indicated the severity of TNF-mediated vascular inflammation and concurrent CALs. According to the progression, these patients might need more targeted therapy of anti-inflammation for a better coronary outcome.",
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AU - Okada, S.

AU - Hasegawa, S.

AU - Suzuki, Y.

AU - Matsubara, T.

AU - Shimomura, M.

AU - Okuda, M.

AU - Ichiyama, T.

AU - Ohga, S.

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