Analysis of Kawasaki disease showing elevated antibody titres of Yersinia pseudotuberculosis.
OBJECTIVE
To elucidate a clinical difference between patients with Kawasaki disease documented with Yersinia pseudotuberculosis infection and patients with Kawasaki disease without Yersinia pseudotuberculosis infection.


METHODS
From January 1985 to July 2004, 452 patients were diagnosed with Kawasaki disease. Forty-two patients had elevated antibody titres of Yersinia pseudotuberculosis and/or positive stool culture (Yersinia-positive group). Three hundred and thirty patients had no elevated antibody titres (Yersinia-negative group). We compared the clinical characteristics retrospectively.


RESULTS
The age of onset in the Yersinia-positive group (3.05+/-2.20 y) was significantly higher than that in the Yersinia-negative group (2.31+/-2.05 y) (p=0.03). The age-adjusted statistical analysis demonstrated that the incidence of coronary artery lesions (dilatations plus aneurysms) in the Yersinia-positive group (22/42, 52.4%) was significantly higher than in the Yersinia-negative group (105/330, 31.8%) (p=0.001), and the incidence of additional administration of immunoglobulin in the Yersinia-positive group (13/36, 36.1%) was significantly higher than in the Yersinia-negative group (41/256, 16.0%) (p=0.004).


CONCLUSIONS
Our data suggest that Yersinia pseudotuberculosis infection might play a role in the developing mechanism of poor response to therapy and the tendency to develop coronary artery lesions in Kawasaki disease patients.
Tahara
Masahiro
M
Department of Paediatrics, Tsuchiya General Hospital, Hiroshima, Japan. mttahara@qg7.so-net.ne.jp
Baba
Kiyoshi
K
Waki
Kenji
K
Arakaki
Yoshio
Y
D000907:Antibodies, Bacterial / Q000302:isolation & purification*; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D015011:Yersinia pseudotuberculosis / Q000276:immunology* / Q000302:isolation & purification; D015012:Yersinia pseudotuberculosis Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000907:Antibodies, Bacterial; D016756:Immunoglobulins, Intravenous