The Journal of Pediatrics
Volume 156, Issue 5 , Pages 792-797, May 2010

Urinary Cytokines and Renal Doppler Study in Kawasaki Disease

  • Jing-Ming Wu, MD

      Affiliations

    • Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
    • ,
  • Yuan-Yow Chiou, MD, PhD

      Affiliations

    • Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
    • ,
  • Wen-Pin Hung, MD

      Affiliations

    • Department of Pediatrics, Kuo General Hospital, Tainan, Taiwan
    • ,
  • Nan-Tsing Chiu, MD, MSc

      Affiliations

    • Department of Nuclear Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
    • ,
  • Mei-Ju Chen, MS

      Affiliations

    • Department of Nursing, Chung Hwa Institute of Technology, Tainan, Taiwan
    • ,
  • Jieh-Neng Wang, MD

      Affiliations

    • Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
    • Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
    • Corresponding Author InformationReprint requests: Jieh-Neng Wang, MD, Department of Pediatrics, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan 70421, Taiwan.

Received 25 June 2009; received in revised form 13 October 2009; accepted 13 November 2009. published online 22 February 2010.

Objective

To investigate whether renal vasculitis is the sole cause or merely a contributing cause of renal inflammation in Kawasaki disease (KD).

Study design

This prospective study in a university medical center in Taiwan enrolled 24 children with KD between June 2004 and November 2005. All patients underwent a technetium-99 m dimercaptosuccinic acid scintigraphy single-photon emission computed tomography scan, the results of which were used to group the patients with KD as with or without renal involvement. Urine samples underwent a cytokine analysis. Renal Doppler ultrasonography was used to evaluate renal vasculitis by measuring the pulsatility index (PI) and resistance index (RI).

Results

Ten of the 24 patients (42%) with renal inflammatory foci were the study group; the remainder composed the control group. Urinary interleukin (IL)-6 levels were significantly higher in the study group (496.7 ± 310.9 vs 115.0 ± 65.9 ng/g urinary creatinine; P < .01), as were PI values (1.85 ± 0.70 vs 1.44 ± 0.53; P < .05). Urinary IL-6 levels and PI values were significantly (P < .05) correlated.

Conclusions

Increased urinary IL-6 and elevated renal Doppler measures suggest that immune-mediated vasculitis is one of the mechanisms causing renal inflammation in KD.

Cr, Creatinine, DMSA, Dimercaptosuccinic acid, IL, Interleukin, IVIG, Intravenous immunoglobulin, KD, Kawasaki disease, PI, Pulsatility index, RI, Resistance index, S/D ratio, Systolic/diastolic velocity ratio, SPECT, Single-photon emission computed tomography

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 Part of this study was presented at the IX International Kawasaki Symposium, Taipei, Taiwan, 2008.

 Supported by National Cheng Kung University Hospital (Grant NCKUH-970216). The authors declare no conflicts of interest.

PII: S0022-3476(09)01155-X

doi:10.1016/j.jpeds.2009.11.046

The Journal of Pediatrics
Volume 156, Issue 5 , Pages 792-797, May 2010

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