Yersinia pseudotuberculosis infection in Kawasaki disease and its clinical characteristicsReport as inadecuate




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BMC Pediatrics

, 15:177

First Online: 11 November 2015Received: 10 November 2014Accepted: 23 October 2015

Abstract

BackgroundThe etiology of Kawasaki disease KD is unknown. Reportedly, there is an association between KD and Yersinia pseudotuberculosis YPT. Steroid therapy for KD patients with high risk of cardiac sequelae CS has been reported; however, the number of reports is limited.

MethodsWe conducted a prospective study of 108 patients with newly diagnosed KD in one year to determine how many KD patients have positive anti-YPT antibody titers and-or positive anti-YPT-derived mitogen YPM antibody titers. In addition, we tried to identify clinical differences between KD patients in whom YPT infection was or not a contributing factor. We also compared clinical characteristics of patients treated with the protocol of the Randomized controlled trial to Assess Immunoglobulin plus Steroid Efficacy for Kawasaki disease RAISE study RAISE group and with the conventional Intravenous immunoglobulin IVIG protocol conventional group.

ResultsEleven patients 10 % were positive for anti-YPT and-or anti-YPM antibodies positive group and 97 90 % were negative negative group. Cardiac sequelae CS occurred significantly more frequently in the positive than the negative group two patients, 18 % vs one patient, 1 %, p = 0.027. Forty patients were in the RAISE group. Two of 40 5 % in the RAISE group and one of 68 1.47 % in the conventional group had CS p = 0.55.

ConclusionsKD patients with YPT infection had CS significantly more frequently and treatment with RAISE protocol did not decrease the frequency of CS in our cohort, nor did YPT infection affect risk scores of no response to IVIG. However, our sample size was overly small to draw such conclusions. Further investigation in a larger cohort is necessary to confirm our findings. Additionally, further research is needed to determine whether early diagnosis of YPT can prevent KD from developing and reduce the incidence of CS.

AbbreviationsKDKawasaki disease

YPTYersinia pseudotuberculosis

YPMY. pseudotuberculosis-derived mitogen

CSCardiac sequelae

RAISERandomized controlled trial to Assess Immunoglobulin plus Steroid Efficacy for Kawasaki disease

VIGIntraVenous ImmunoGlobulin

CRPC-reactive protein

PSLPrednisolone

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