title: Analysis of Kawasaki disease showing elevated antibody titres of Yersinia pseudotuberculosis.
abstract: 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.
authors.affiliation: Department of Paediatrics, Tsuchiya General Hospital, Hiroshima, Japan. mttahara@qg7.so-net.ne.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tahara
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Baba
authors.forename: Kenji
authors.initials: K
authors.lastname: Waki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Arakaki
mesh_terms: 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
chemical_list: D000907:Antibodies, Bacterial; D016756:Immunoglobulins, Intravenous