Soluble forms of the selectin family in children with Kawasaki disease: prediction for coronary artery lesions.
OBJECTIVE
To investigate the relationship between the plasma levels of soluble forms of the selectin family and the incidence of coronary artery lesions (CALs) in patients with Kawasaki disease (KD).


METHODS
Thirty-three patients with KD, including group A patients (n = 22) who had no CALs and group B patients (n = 11) who had CALs, as well as age-matched febrile (n = 10) and afebrile controls (n = 11), were studied.


RESULTS
Peak plasma E-selectin levels (172.0 +/- 58.6 ng ml(-1)) occurred during the acute phase of KD, while peak plasma P-selectin levels (260.3 +/- 43.2 ng ml(-1)) occurred during the subacute phase of the illness (p<0.05). Plasma L-selectin levels (1757.3 +/- 244.3 ng ml(-1)) during the convalescent phase tended to be higher than in either the acute or the subacute phase (not significant). Before intravenous immunoglobulin treatment, the plasma levels of E- (225.1 +/- 46.8 ng ml(-1)) and P-selectin (259.4 +/- 76.2 ng ml(-1)) of patients with CALs (n = 11) were significantly higher than those of patients (n = 22) with no CALs (E-selectin, 131.6 +/- 36.9 ng ml(-1); P-selectin, 184.9 +/- 84.6 ng ml(-1); p < 0.05). When a plasma E-selectin value before immunoglobulin treatment of >184.7 ng ml(-1) was used as the cut-off point, the sensitivity and specificity for the incidence of CALs were 81.8% and 90.9%, respectively. These findings demonstrate the relationship between plasma levels of selectins and disease severity of Kawasaki vasculitis.


CONCLUSIONS
Higher plasma levels of E-selectin may have potential as a predictor of the incidence of coronary artery lesions in Kawasaki disease patients.
Furui
J
J
Department of Pediatrics, Cardiovascular Research Institute, Kurume University School of Medicine, Kurume, Japan.
Ishii
M
M
Ikeda
H
H
Muta
H
H
Egami
K
K
Sugahara
Y
Y
Himeno
W
W
Akagi
T
T
Kato
H
H
Matsuishi
T
T
D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000097:blood*; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D007700:Kinetics; D016015:Logistic Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood*; D012995:Solubility
D019040:E-Selectin