A shared inflammatory signature between patients with pediatric Kawasaki disease (KD) and adult patients with Kawasaki-like syndrome (KLS) suggest a link to a common etiologic agent, according to research published in Open Forum Infectious Diseases.

Using a custom multiplex enzyme-linked immunosorbent assay (ELISA), Raymond M. Johnson, MD, PhD, section of infectious diseases, department of medicine, Yale School of Medicine, and colleagues were able to define serum cytokine mileu in 2 adults presenting with KLS during both acute and convalescent phases; asymptomatic patients with HIV who were not taking antiretroviral therapy served as a control group.

The researchers looked prospectively at samples gathered from 29 patients with KD between September 2014 and July 2015. Serum samples from the pediatric patients were collected in 3 different groups: pediatric patients with KD, pediatric patients with febrile illness, and pediatric patients with non-infectious illness. Serum samples were analyzed using a custom multiplex ELISA. 


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Both sets of  patients presented the same inflammatory signature, including acute phase reactants reflecting TNFα biologic activity and endothelial/smooth muscle chemokines Ccl1, Ccl2, and Cxcl11.

“The KD/KLS inflammatory signature based on elevated acute phase reactants and specific endothelial/smooth muscle chemokines was able to identify KD subjects versus febrile controls, and may serve as a practicable diagnostic test for KD,” the researchers concluded.

Reference

1. Johnson RM, Bergmann KR, Manaloor JJ, et al. Pediatric Kawasaki Disease and adult HIV Kawasaki-like Syndrome are likely the same malady. Open Forum Infect Dis. 2016; doi: 10.1093/ofid/ofw160.