Abstract 40: A Prospective Study on the Association of Kawasaki Disease and Mycoplasma pneumoniae Infection

Abstract

Objective: The etiology of Kawasaki disease(KD) remains unknown, and several infectious agents have been proposed as the etiology of KD. There have been some studies, stating that KD and Mycoplasma pneumoniae(M. pneumoniae) infection are linked. So authors performed a prospective study to elucidate whether there is association between KD and M. pneumoniae infection. Subjects and Methods: Subjects are 36 patients with KD who admitted to Bundang Jesaeng General Hospital from January 2013 through August 2014. Patients were assigned to the M. pneumoniae group and the control group according to anti-mycoplasmal IgM antibody(AMA) titers. Clinical features, laboratory findings, courses and outcomes were compared between two groups. Results: AMA were positive or indeterminate in 11 patients(30.6%; M. pneumoniae group) and were negative in 25 patients(69.4%; control group). There were no significant differences between two groups in age and sex distributions, duration of fever, laboratory findings(WBC counts, ESR, CRP, AST, ALT, bilirubin), chest X-ray findings, and echocardiographic abnormalities(coronary arterial lesion, pericardial effusion, valvular regurgitation, LV dysfunction). AMA titers were rechecked in 6 patients, of whom 5(83.3%) showed decreased titers and 1(16.7%) showed an increased titer. All of patients were treated successfully with intravenous immunoglobulin and oral aspirin. Conclusion: Although AMA was detected in some patients with KD, it did not affect clinical features, laboratory findings, courses and outcomes of KD. In most cases AMA titers were decreased in the second examinations, so authors think that M. pneumoniae infection was a previous infection rather than a concurrent infection in some patients with KD and it did not act as a causative agent of KD.