Urinary cytokines and renal Doppler study in Kawasaki disease.
OBJECTIVE
To investigate whether renal vasculitis is the sole cause or merely a contributing cause of renal inflammation in Kawasaki disease (KD).


METHODS
This prospective study in a university medical center in Taiwan enrolled 24 children with KD between June 2004 and November 2005. All patients underwent a technetium-99 m dimercaptosuccinic acid scintigraphy single-photon emission computed tomography scan, the results of which were used to group the patients with KD as with or without renal involvement. Urine samples underwent a cytokine analysis. Renal Doppler ultrasonography was used to evaluate renal vasculitis by measuring the pulsatility index (PI) and resistance index (RI).


RESULTS
Ten of the 24 patients (42%) with renal inflammatory foci were the study group; the remainder composed the control group. Urinary interleukin (IL)-6 levels were significantly higher in the study group (496.7 +/- 310.9 vs 115.0 +/- 65.9 ng/g urinary creatinine; P < .01), as were PI values (1.85 +/- 0.70 vs 1.44 +/- 0.53; P < .05). Urinary IL-6 levels and PI values were significantly (P < .05) correlated.


CONCLUSIONS
Increased urinary IL-6 and elevated renal Doppler measures suggest that immune-mediated vasculitis is one of the mechanisms causing renal inflammation in KD.
Wu
Jing-Ming
JM
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Chiou
Yuan-Yow
YY
Hung
Wen-Pin
WP
Chiu
Nan-Tsing
NT
Chen
Mei-Ju
MJ
Wang
Jieh-Neng
JN
D001783:Blood Flow Velocity; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000652:urine; D007668:Kidney / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000652:urine; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging* / Q000652:urine*; D011673:Pulsatile Flow; D019275:Radiopharmaceuticals; D012077:Renal Artery / Q000000981:diagnostic imaging; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015899:Tomography, Emission-Computed, Single-Photon; D018617:Ultrasonography, Doppler, Pulsed; D014655:Vascular Resistance; D014657:Vasculitis / Q000000981:diagnostic imaging / Q000652:urine
D015850:Interleukin-6; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D003404:Creatinine