Diagnostic value of anti-neutrophil cytoplasmic and anti-endothelial cell antibodies in early Kawasaki disease.
OBJECTIVE
To assess the diagnostic potential of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-endothelial cell antibodies (AECA) to distinguish early Kawasaki disease (KD) from febrile diseases resembling KD.


METHODS
Case-control study.


METHODS
Tertiary care facility.


METHODS
Eighteen patients with KD tested within 2 weeks of disease onset and before immune globulin therapy; 20 control children with fever and at least one other KD criterion; 21 children with noninflammatory disorders (patients scheduled for elective surgery, or after trauma).


METHODS
We detected ANCA by immunofluorescence and enzyme-linked immunosorbent assay (ELISA), and AECA by a cell-ELISA with fixed human umbilical vein endothelial cells.


RESULTS
We found that 7 of 18 patients with KD and 6 of 20 febrile control patients had ANCA (by immunofluorescence or ELISA, p value not significant); 3 of 18 patients with KD and 8 of 20 febrile control patients had AECA (p value not significant). One of three patients with KD who had aneurysms had ANCA; none had AECA.


CONCLUSIONS
The ANCA and AECA tests used in this study did not differentiate early KD from other childhood diseases with which it may be confused.
Guzman
J
J
Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Fung
M
M
Petty
R E
RE
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000276:immunology
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D015415:Biomarkers; C087589:anti-endothelial cell antibody