Clinical significance of serum cytokine profiles for differentiating between Kawasaki disease and its mimickers

Kaneko, Shuya; Shimizu, Masaki; Shimbo, Asami; Irabu, Hitoshi; Yokoyama, Koji; Furuno, Kenji; Tanaka, Takayuki; Ueno, K.; Fujita, Shuhei; Iwata, Nakao; Fujimura, Junya; Akamine, Keiji; Mizuta, Mao; Nakagishi, Yasuo; Minato, Toshinori; Watanabe, Kenji; Kobayashi, Anna; Endo, Tamio; Tabata, Katsuhiko; Mori, Masaaki; Morio, Tomohiro

doi:10.1016/j.cyto.2023.156280

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…Despite the overlapping clinical manifestations, some differences exist in immunological phenotypes between MIS-C and KD, including higher production of proinflammatory cytokines, such as interferon-γ and IL-18, along with increased activation of some T-cell phenotypes. 2–4,9 Furthermore, this study showed specific expansions of TCR-Vβ 21.3 + CD4 + T cells and CD8 + T cells in most of the patients with MIS-C, whereas this finding was not observed in patients with KD. Thus, the combination of serum cytokine profile and T-cell receptor Vβ repertoire analysis might be clinically useful for differentiating MIS-C from KD.…”

Section: Discussionmentioning

confidence: 54%

“…8 Previously, we reported that patients with MIS-C showed a similar pattern of serum cytokine profile to TSS caused by superantigens with SA and Ypt . 9 These findings indicate that superantigens, peptide antigens comprising the spike protein S1 subunit of SARS-CoV-2, might play an important role in MIS-C pathogenesis. 2,3 In this study, we demonstrated that specific expansions of TCR-Vβ 21.3 + CD4 + T cells and CD8 + T cells observed in most patients with MIS-C were not observed in patients with TSS.…”

Section: Discussionmentioning

confidence: 85%

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Clinical Usefulness of T-Cell Receptor Vβ Repertoire Analysis for Differentiating Multisystem Inflammatory Syndrome in Japanese Children From Toxic Shock Syndrome and Kawasaki Disease

Kaneko,

Noguchi,

Hatano

et al. 2023

Pediatric Infectious Disease Journal

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The specific expansion of T-cell receptor β chain variable region (TCR-Vβ21.3+) CD4+ and CD8+ T cells was observed in Japanese patients with multisystem inflammatory syndrome in children. In contrast, these findings were not observed in patients with toxic shock syndrome and Kawasaki disease. T-cell receptor β chain variable region repertoire analysis to detect specific expansion of Vβ21.3+ T cells might be useful for differentiating multisystem inflammatory syndrome in children from toxic shock syndrome and Kawasaki disease.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 85%

Clinical Usefulness of T-Cell Receptor Vβ Repertoire Analysis for Differentiating Multisystem Inflammatory Syndrome in Japanese Children From Toxic Shock Syndrome and Kawasaki Disease

Kaneko,

Noguchi,

Hatano

et al. 2023

Pediatric Infectious Disease Journal

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Risk factors and an early predictive model for Kawasaki disease shock syndrome in Chinese children

Zhang,

Wang,

et al. 2024

Ital J Pediatr

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Background Kawasaki disease shock syndrome (KDSS), though rare, has increased risk for cardiovascular complications. Early diagnosis is crucial to improve the prognosis of KDSS patients. Our study aimed to identify risk factors and construct a predictive model for KDSS. Methods This case-control study was conducted from June, 2015 to July, 2023 in two children’s hospitals in China. Children initially diagnosed with KDSS and children with Kawasaki disease (KD) without shock were matched at a ratio of 1:4 by using the propensity score method. Laboratory results obtained prior to shock syndrome and treatment with intravenous immunoglobulin were recorded to predict the onset of KDSS. Univariable logistic regression and forward stepwise logistic regression were used to select significant and independent risk factors associated with KDSS. Results After matching by age and gender, 73 KDSS and 292 KD patients without shock formed the development dataset; 40 KDSS and 160 KD patients without shock formed the validation dataset. Interleukin-10 (IL-10) > reference value, platelet counts (PLT) < 260 × 109/L, C-reactive protein (CRP) > 80 mg/ml, procalcitonin (PCT) > 1ng/ml, and albumin (Alb) < 35 g/L were independent risk factors for KDSS. The nomogram model including the above five indicators had area under the curves (AUCs) of 0.91(95% CI: 0.87–0.94) and 0.90 (95% CI: 0.71–0.86) in the development and validation datasets, with a specificity and sensitivity of 80% and 86%, 66% and 77%, respectively. Calibration curves showed good predictive accuracy of the nomogram. Decision curve analyses revealed the predictive model has application value. Conclusions This study identified IL-10, PLT, CRP, PCT and Alb as risk factors for KDSS. The nomogram model can effectively predict the occurrence of KDSS in Chinese children. It will facilitate pediatricians in early diagnosis, which is essential to the prevention of cardiovascular complications.

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Diagnostic Value of Interleukin-6 in Acute Kawasaki Disease: A Retrospective Study

Zhu,

Yuan,

Dai

et al. 2024

Preprint

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Purpose Kawasaki disease (KD) is an acute vasculitis affecting mainly young children and can cause serious coronary artery abnormalities. This study evaluated interleukin-6 (IL-6) as a biomarker for early KD diagnosis and treatment. Methods In a retrospective study, 275 children with acute KD were analyzed, alongside 109 children with other infectious diseases, to assess IL-6's diagnostic specificity. Patients were categorized by coronary artery lesions (CAL) presence and KD type. Results Of the KD patients (mean age 2.45 years), 84 had CAL. IL-6 levels were significantly higher in patients with CAL (223.56 pg/mL) versus without (95.18 pg/mL, p < 0.05) and compared to other infectious diseases (134.86 pg/mL vs. 33.38 pg/mL, p < 0.05). The optimal IL-6 cutoff for predicting CAL had a sensitivity and specificity of 0.6. IL-6 correlated with C-reactive protein (r = 0.404), but no difference was found between typical and incomplete KD. Conclusions Elevated IL-6 levels in acute KD, particularly with CAL, suggest its utility as a diagnostic biomarker. Further studies are needed to confirm IL-6's diagnostic role.

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Clinical significance of serum cytokine profiles for differentiating between Kawasaki disease and its mimickers

Cited by 3 publications

References 37 publications

Clinical Usefulness of T-Cell Receptor Vβ Repertoire Analysis for Differentiating Multisystem Inflammatory Syndrome in Japanese Children From Toxic Shock Syndrome and Kawasaki Disease

Clinical Usefulness of T-Cell Receptor Vβ Repertoire Analysis for Differentiating Multisystem Inflammatory Syndrome in Japanese Children From Toxic Shock Syndrome and Kawasaki Disease

Risk factors and an early predictive model for Kawasaki disease shock syndrome in Chinese children

Diagnostic Value of Interleukin-6 in Acute Kawasaki Disease: A Retrospective Study

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