Kawasaki disease shock syndrome: clinical characteristics and possible use of IL-6, IL-10 and IFN-γ as biomarkers for early recognition

• DOI: 10.1186/s12969-018-0303-4
• Publication Date: 2019-01-05T13:22:28Z
• Authors: Yandie Li; Qi Zheng; Lixia Zou; Jianqiang Wu; Li Guo; Liping Teng; Rongjun Zheng; Lawrence Kwok Leu...; Meiping Lu
• Keywords: Male; Kawasaki disease; Immunoglobulins, Intravenous; Infant; Clinical features; Shock; Diseases of the musculoskeletal system; Mucocutaneous Lymph Node Syndrome; Flow Cytometry; Pediatrics; RJ1-570; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; RC925-935; ROC Curve; Child, Preschool; Cytokines; Humans; Female; Child; Biomarkers; Research Article; Retrospective Studies

As an acute febrile and inflammatory disease, Kawasaki disease (KD) could develop shock syndrome (KDSS) sometimes. However its pathogenesis was still not well known. This study to learn more about the clinical features evaluate role of cytokines in KDSS.We collected laboratory data retrospectively for all patients with KDSS(KDSS, n = 27)who were hospitalized at our hospital from Jan 2014 Oct 2017. For patient KDSS, we randomly identified 43 KD as control subjects (KD, 43). Clinical features, evaluations collected. Cytokines IL-2, IL-4, IL-6, IL-10, TNF-α IFN-γ serum assayed using flow cytometric bead array.The KDSS older age (43.41 ± 31.42 vs 28.81 21.51 months, P < 0.05), longer duration fever (10.63 5.12 6.98 2.45 days, higher WBC count, neutrophils, CRP, ESR, PCT D-dimer, lower hemoglobin albumin, severe hyponatremia hypokalemia, refractory IVIG therapy, coronary artery abnormalities (CAAs), aseptic meningitis, hospitalization than (all 0.05). The levels IL-6 [184.1 (27.7-2577.3) 54.1 (4-425) pg/ml], IL-10 [42.6 (5-236.7) 9.4 (3-94) [2.6 (1.0-23.4) 2.1 (1-6) pg/ml] [18.3 (4.5-94.4) 6.7 (2-56) significant ROC curves showed that 66.7 pg/ml 20.85 8.35 had sensitivity specificity identifying 85.2 62.8%; 83.7%; 74.1 74.4% respectively. No fatality recorded this series.KDSS characteristic cytokine production prone developing non-responsiveness CAAs. above pg/ml, suggested risk KDSS.