Acute Febrile Mucocutaneous Lymph Node Syndrome

Yanagihara, Richard

doi:10.1001/archpedi.1980.02130180059017

Cited by 42 publications

(18 citation statements)

References 77 publications

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“…KD patients were classified as having complete or incomplete KD on the basis of their complete or incomplete fulfillment of the diagnostic clinical criteria established by the Kawasaki Study Group (41). All 38 KD patients were judged by one of two experienced clinicians (M.E.M.…”

Section: Resultsmentioning

confidence: 99%

Elevated Levels of Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 during the Acute Phase of Kawasaki Disease

Chua

Melish

et al. 2003

Clin Vaccine Immunol

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Kawasaki disease (KD) is an acute, self-limiting, multisystem vasculitis of unknown etiology affecting infants and young children. Unless treated promptly with high-dose intravenous gamma globulin and aspirin, patients frequently develop coronary aneurysms. Previously, matrix metalloproteinase 9 (MMP-9), which is secreted complexed to tissue inhibitor of metalloproteinase 1 (TIMP-1), has been implicated in abdominal aortic aneurysm formation. Since the clinical and pathological features of KD include inflammation and weakening of blood vessels, we analyzed acute-and convalescent-phase paired plasma or serum samples from 31 KD patients, 7 patients who did not completely meet the criteria for KD, and 26 non-KD controls (9 febrile and 17 afebrile patients) for pro-MMP-9 (92 kDa) enzyme activity by gelatin zymography and for active MMP-9 (83 kDa), pro-MMP-9, and TIMP-1 protein levels by enzyme-linked immunosorbent assay. Statistical analysis was performed by using Student t tests, linear regression, and the Wilcoxon rank-sum test. Markedly elevated pro-MMP-9 enzymatic activity, pro-MMP-9 protein levels, and TIMP-1 protein levels were found during the acute phase of illness in patients with clinically established KD and in patients who were suspected of having KD but did not meet all of the criteria. There was no significant difference in active MMP-9 levels. Furthermore, pro-MMP-9 and TIMP-1 protein levels were significantly elevated among KD patients, compared to those of febrile and afebrile non-KD controls. The significantly elevated pro-MMP-9 enzyme and protein levels during the acute phase of KD may reflect vascular remodeling or an inflammatory response to a microbial agent, suggesting a pathophysiological role for MMP-9 in coronary aneurysm formation.

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Section: Resultsmentioning

confidence: 99%

Elevated Levels of Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 during the Acute Phase of Kawasaki Disease

Chua

Melish

et al. 2003

Clin Vaccine Immunol

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“…Kawasaki syndrome (KS)' is an acute febrile illness of early childhood characterized by diffuse mucosal inflammation, in-durative edema of the hands and feet, polymorphous skin rash, and nonsuppurative cervical lymphadenopathy (1,2). This disease has aroused much interest because it has been associated with sudden death due to coronary arteritis accompanied by coronary aneurysms and thrombotic occlusion (3,4).…”

Section: Introductionmentioning

confidence: 99%

Immunoglobulin M antibodies present in the acute phase of Kawasaki syndrome lyse cultured vascular endothelial cells stimulated by gamma interferon.

Leung¹,

Collins²,

Lapierre³

et al. 1986

J. Clin. Invest.

237

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“…Less common features ( Table 2) that have been reported include arthritis [9], aseptic meningitis [9,11], deranged liver enzyme levels [12], and aortic and/or mitral insufficiency [13,14].…”

Section: Discussionmentioning

confidence: 99%

Kawasaki Disease in Kuwait: A Prospective Study of 41 Cases

et al. 1990

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Forty-one children with Kawasaki disease were seen over a 12-year period in two regional hospitals in Kuwait. The average annual incidence during the first 8 years of the study was 0.71 per 100,000 children under the age of 10 years and this increased to 3.44 during the last 4 years. The disease occurred throughout the year, with an increased incidence in winter and spring. The male/female ratio was 2.2/1, and 83% of the children were under the age of 5 years. Fever, rash, and oropharyngeal and extremity changes were encountered in all patients, whereas conjunctivitis and cervical adenitis were detected in 85% and 54%, respectively. The mitral valve was affected in two patients and the aortic valve in one. Of the 19 patients evaluated by echocardiographic studies, three (16%) showed evidence of coronary vasculitis. There was no mortality. The basic clinical and epidemiological features of Kawasaki disease in this area corroborate previously well-recognized findings.

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Acute Febrile Mucocutaneous Lymph Node Syndrome

Cited by 42 publications

References 77 publications

Elevated Levels of Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 during the Acute Phase of Kawasaki Disease

Elevated Levels of Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 during the Acute Phase of Kawasaki Disease

Immunoglobulin M antibodies present in the acute phase of Kawasaki syndrome lyse cultured vascular endothelial cells stimulated by gamma interferon.

Kawasaki Disease in Kuwait: A Prospective Study of 41 Cases

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