Changes in and significance of platelet function and parameters in Kawasaki disease

Zheng, Xiaolan; Wu, Wenchao; Zhang, Yi; Wu, Gang

doi:10.1038/s41598-019-54113-1

Cited by 13 publications

(9 citation statements)

References 52 publications

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“…An increase in PLT count in children with KD is usually associated with exacerbation of inflammation [ 23 ]. Therefore, the present study examined the altered levels of cytokines in patients treated with or without clopidogrel during IVIG therapy.…”

Section: Resultsmentioning

confidence: 99%

Predictive Role of IL-2R and IL-10 in the Anti-inflammatory Response and Antiplatelet Therapy of Kawasaki Disease: A Retrospective Study

Zhang

Chen

Sun

et al. 2022

Mediators of Inflammation

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To date, Kawasaki disease (KD) has only been able to be diagnosed and evaluated using clinical characteristics. Additionally, the therapeutic effect and cardiovascular complications could not be verified until its occurrence. The present retrospective study analyzed the dynamic alterations of inflammatory cytokines, platelet (PLT) count, and subgroups of lymphocytes, such as cluster of differentiation (CD) 8+ T cells and CD19+ B cells, under different conditions in 64 children with KD. The percentage distribution of lymphocyte subgroups and the altered neutrophil lymphocyte ratio demonstrated that the inflammatory response was dominated by the B cell-mediated humoral immune response before intravenous immunoglobulin (IVIG) treatment, but mainly by T cells via cellular cytotoxic effects after IVIG treatment. Among the different types of inflammatory cytokines, the results of the present study revealed that the altered levels of interleukin-2 receptor (IL-2R) and interleukin-10 (IL-10) were closely associated with the percentage of CD8+ T cells and CD19+ B cells. Additionally, the two cytokines exhibited more sensitive fluctuations based on the status of the children with KD in various circumstances compared with other indexes, such as the percentages of CD8+ T cells and CD19+ B cells or the PLT count. These results suggested that children with KD who are ≥4 years old may benefit from IVIG but will not benefit from decreased platelet activation or suffer less cardiovascular complications. Additionally, starting clopidogrel usage earlier as an antiplatelet strategy should be considered based on the observed continuous rise in the PLT count in children with KD receiving IVIG. In conclusion, dynamically monitoring the levels of IL-2R and IL-10 has the potential to provide indications of the intensity and development of the inflammatory response in children with KD and may contribute to the early prediction and adjustment of pathological and pharmacological effects of therapy.

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Section: Resultsmentioning

confidence: 99%

Predictive Role of IL-2R and IL-10 in the Anti-inflammatory Response and Antiplatelet Therapy of Kawasaki Disease: A Retrospective Study

Zhang

Chen

Sun

et al. 2022

Mediators of Inflammation

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“…More significantly, despite the decreased incidence of virus infection in group 2 compared with group 1, the same frequency of IVIG response and CALs or nCALs was observed, which could imply a loose association between IVIG resistance, CALs and concurrent virus infection in patients with KD [ 27 ]. Prior studies also indicated that coronary artery abnormality (and the response to IVIG) in the children with KD may be related to the extent of inflammation (such as greater CRP), not to whatever pathogen is present [ 29 – 31 ]. In addition, during laboratory testing, the increased value of neutrophil percentage differing from that of the past 5 years, could be associated with the higher ratio of concurrent MP infection.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Kawasaki disease and concurrent pathogens during isolation in COVID-19 pandemic

et al. 2021

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Background The aim of this study is to explore the characteristics of Kawasaki disease (KD) and concurrent pathogens due to a stay-at-home isolation policy during coronavirus disease 2019 (COVID-19) epidemic. Methods All patients with KD admitted between February and April in 2015–2020, were classified into before (group 1, in 2015–2019) and after (group 2, in 2020) isolation groups. A total of 4742 patients [with KD ( n = 98) and non-KD ( n = 4644)] referred to Mycoplasma pneumoniae (MP) and virus detection were analyzed in 2020. Clinical characteristics, laboratory data, and 13 pathogens were analyzed retrospectively. Results Group 2 had a significantly increased incidence of KD (0.11%) with 107 patients compared to that of group 1 (0.03%) with 493 patients. The comparisons of oral mucosal change, strawberry tongue, desquamation of the fingertips, cervical lymphadenopathy and neutrophil percentage decreased in group 2 compared to group 1. The infection rate of MP increased significantly in group 2 (34.7%) compared to group 1 (19.3%), while the positive rate of viruses decreased significantly in group 2 (5.3%) compared to group 1 (14.3%). In 2020, the positive rate of MP infection increased significantly in patients with KD compared to the increase in patients with non-KD. The infection rate of MP for younger children aged less than 3 years old was higher in group 2 than in group 1. Conclusion Compared with the characteristics of KD from 2015 to 2019 years, the incidence of KD was increased in 2020 and was accompanied by a high incidence of MP infection, especially in younger children (less than 3 years old) during the isolation due to COVID-19 pandemic.

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“…Initial treatment of intravenous immunoglobulin (IVIG) can reduce the incidence of CAL. 31 However, some children with KD show complete nonresponse or only a partial response to IVIG. These children may have immune tolerance to this treatment.…”

Section: Features Of Ikdmentioning

confidence: 99%

Correct identification of incomplete Kawasaki disease

Feng

et al. 2021

J Int Med Res

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Incomplete Kawasaki disease (IKD) is characterized by a longer fever time, younger age of onset, and higher incidence of coronary artery disease compared with complete Kawasaki disease. Kawasaki disease is often difficult to diagnose early because of its incomplete clinical symptoms. This issue could delay treatment and harm the health of the child. This article reviews the clinical characteristics and pathogenesis of IKD to help clinicians understand the symptoms of IKD, make the correct diagnosis, and provide timely treatment.

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Changes in and significance of platelet function and parameters in Kawasaki disease

Cited by 13 publications

References 52 publications

Predictive Role of IL-2R and IL-10 in the Anti-inflammatory Response and Antiplatelet Therapy of Kawasaki Disease: A Retrospective Study

Predictive Role of IL-2R and IL-10 in the Anti-inflammatory Response and Antiplatelet Therapy of Kawasaki Disease: A Retrospective Study

Clinical characteristics of Kawasaki disease and concurrent pathogens during isolation in COVID-19 pandemic

Correct identification of incomplete Kawasaki disease

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