The characterization of cerebrospinal fluid and serum cytokines in patients with Kawasaki disease.
BACKGROUND
The central nervous system (CNS) inflammation of Kawasaki disease (KD) has not been sufficiently evaluated in spite of the complications of irritability and CSF pleocytosis.


METHODS
Cerebrospinal fluid (CSF) and serum inflammatory cytokine values were simultaneously examined in 10 patients (2.6 +/- 2.1 year of age) during the acute phase. They were all irritable and demonstrated mild consciousness disturbance.


RESULTS
The CSF IL6 was elevated (>3.0 pg/mL) in 6 patients, and 4 of them showed higher CSF than serum values. The CSF sTNFR1 was elevated (>0.5 microg/mL) in 6 patients, and 1 showed higher CSF than serum values. These CSF cytokine (IL6; 81.4 +/- 192.8 pg/mL, sTNFR1; 1.1 +/- 0.8 microg/mL) and CSF/serum ratio (IL6; 2.8 +/- 5.2, sTNFR1 0.4 +/- 0.4) in patients with KD were the same as those of patients with acute encephalitis/acute encephalopathy.


CONCLUSIONS
The differences in the inflammatory cytokine value between CSF and serum suggest that the degree of systemic vasculitis is different between CSF and the circulating blood, and some patients with KD showed a higher degree of CSF inflammation.
Korematsu
Seigo
S
Division of Pediatrics and Child Neurology, Department of Brain and Nerve Science, Oita University Faculty of Medicine, Oita, Japan. kseigo@med.oita-u.ac.jp
Uchiyama
Shin-ichi
S
Miyahara
Hiroaki
H
Nagakura
Tomokazu
T
Okazaki
Naho
N
Kawano
Tatsuya
T
Kojo
Masanobu
M
Izumi
Tatsuro
T
D002648:Child; D002675:Child, Preschool; D003244:Consciousness Disorders; D016207:Cytokines / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007223:Infant; D007508:Irritable Mood; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000276:immunology*
D016207:Cytokines