IMMUNOLOGICAL FINDINGS IN KAWASAKI-DISEASE - AN EVALUATION IN A COHORT OF ITALIAN CHILDREN

Objective. Multiple humoral and cellular abnormalities in Kawasaki dis ease (KD) have already been described. In this study an analysis of im munological findings in a cohort of 34 Italian children affected with KD is reported, and the potential clinical significance of such altera tions in predicting the development of coronary aneurysm and the progn osis of the disease is evaluated. Methods. Levels of circulating immun e complexes (CIC), antinuclear antibodies (ANA), anticardiolipin (aCL) , antineutrophil cytoplasmic antibodies (ANCA), and anti-endothelial c ells (AECA) and the T cell profile were determined in both the acute a nd the convalescent phases, and were compared to febrile, sex- and age -matched children. Results. CIC were present in 66% of the patients, 1 8 of whom were in the acute phase and 13 in the convalescent phase. In the control group CIC were detected in 47% of the children. ANA were negative in both the KD and in the febrile group. ANCA were present in 8%, AECA in 26%, and aCL in 30% of KD patients (Ige aCL antibodies we re found in 14 patients, IgM aCL in 1, and 1 had both). Among the cont rols, aCL antibodies were found in 5 patients (22%); in particular 1 ( 4.4%) had IgG and 4 (17.4%) had IgM aCL. An altered T cell profile, wi th an inverted CD4/CD8 ratio, was found in all KD children. All of the immune alterations showed a lower incidence in the convalescent than in the acute phase. No significant relationship between any of these i mmune findings and cardiac involvement or any other clinical manifesta tions was found. Conclusion, Our data confirms the previously reported immunological anomalies in KD both in the acute and the convalescent phases, with a decreased incidence of such alterations in the convales cent phase. No prognostic significance for the occurrence of aneurysm could be demonstrated.