Relation between Kawasaki Disease and Immunoglobulin E

Chung Mo Koo; Seong Yeol Choi; Dong Soo Kim; Ki Hwan Kim

doi:10.4078/jrd.2013.20.1.4

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Koo, Choi, Kim, and Kim: Relation between Kawasaki Disease and Immunoglobulin E

Original Article

J Rheum Dis 2013;20(1):4-8.

Published online: 31 February 2013

DOI: https://doi.org/10.4078/jrd.2013.20.1.4

Relation between Kawasaki Disease and Immunoglobulin E

Chung Mo Koo, Seong Yeol Choi, Dong Soo Kim, Ki Hwan Kim

Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea

Corresponding to : Ki Hwan Kim, Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, 50, Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. E-mail : KHKIM99@yuhs.ac

Received 3 October 201229 October 2012 Accepted 30 October 2012

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Kawasaki disease is a systemic vascular disease which is caused by an immunologic response. The purpose of this study is to see how a high IgE level affects Kawasaki disease, in two groups of high IgE level and low IgE level.

Methods

A retrospective study was done from 2008 to 2010, among patients, who were admitted in Severance Children's Hospital for Kawasaki disease with IgE levels checked. Age groups with an IgE level above reference ranges and those with normal ranges were done. Also, clinical characteristics were analyzed. Statistical method was done by SPSS 18.

Results

A total of 198 Kawasaki patients were analyzed from 2008 to 2010. Among them 123 (62%) patients showed elevated IgE levels. Patients with high IgE had a significantly higher lymphadenopathy prevalence (p=0.006), however they had no connection with quantitative values. Patients with BCG site redness appeared to have lower IgE levels than patients without redness. Coronary complication had no relation with IgE levels. There was no correlation between laboratory results and IgE levels.

Conclusion

62% of Kawasaki disease patients show high IgE levels in our study. The symptoms of BCG site redness aged less than 1 year seemed to be related with IgE level. To understand the pathophysiology of Kawasaki disease, more studies should be performed on the role of IgE.

Keywords: Kawasaki disease, Immunoglobulin E

References

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Figure 1.

Serum IgE by clinical manifestations. Patients with high IgE had significantly high lymphadenopathy prevalence and patients without BCG site injection appeared to have lower IgE levels than patients with injection. (∗p-value<0.05). Other symptoms had no relation with IgE levels.

Table 1.

Reference values of serum IgE by age

Age	Male (IU/mL)	Female (IU/mL)
0∼12 months	<12	<8
1∼3 years	<90	<28
4∼10 years	<163	<137
11∼18 years	<179	<398

Reference by Soldin SJ, Lenherr S, Kumar A. Pediatric reference ranges for IGE. Clinical Chemistry 1995;41:S92-S. Reference values are 97.5 percentile of serum IgE

Table 2.

Patients’ mean serum IgE level by age

Age	<1 years	1∼3 years	>3 years
IgE (IU/mL)	51.2±85.9	152.1±179.3	261.6±306.5
Patients numbers with high IgE	42/52 (80%)	47/68 (69%)	34/78 (44%)

Table 3.

Laboratory characteristics of patients with IgE values

	High IgE (n=123)	Normal IgE (n=75)	p-value
WBC (/uL)	13,093±4,956	12,908±4,711	0.795
Hemoglobin (g/dL)	12.2±8.7	11.5±1.0	0.463
Lymphocyte (%)	30.6±15.2	26.4±15.8	0.060
Eosinophile (%)	3.6±3.7	3.0±5.9	0.343
Platelet (×10³/uL)	428±171	398±177	0.232
ESR (mm/hr)	62.9±30.5	63.1±36.0	0.965
CRP (mg/L)	59.5±49.8	73.1±80.6	0.192
Albumin (g/dL)	3.9±0.4	3.9±0.5	0.849
AST (IU/L)	63.7±105.1	60.5±90.4	0.829
ALT (IU/L)	69.7±123.0	64.6±94.8	0.756
IgG (mg/dL)	868.0±627.9	780.0±395.1	0.299
IgA (mg/dL)	72.3±54.1	79.6±46.6	0.366
IgM (mg/dL)	123.0±60.5	110.0±39.9	0.080

WBC: white blood cell, ESR: erythrocyte sedimentation rate (normal range 0∼20 mm/hr), CRP: C-reactive protein (normal range 0∼8 mg/L), AST: Aspartate Aminotransferase, ALT: Alanine transaminase

Table 4.

Analysis of clinical symptoms and IgE values in each age group

		Symptom (+)	Symptom (-)	p-value
Rash	<1 years	59.6±99.0 (n=37)	30.4±31.6 (n=15)	0.272
	1∼3 years	131.5±113.5 (n=45)	192.5±263.7 (n=23)	0.187
	>3 years	260.0±326.1 (n=29)	252.9±294.7 (n=49)	0.915
Red lip	<1 years	49.4±89.2 (n=37)	55.6±79.6 (n=15)	0.818
	1∼3 years	159.6±190.0 (n=49)	132.8±151.113 (n=19)	0.584
	>3 years	276.0±320.4 (n=67)	132.6±137.4 (n=11)	0.149
Red eye	<1 years	53.9±92.5 (n=44)	35.8±28.4 (n=8)	0.589
	1∼3 years	156±188.3 (n=52)	139.4±150.9 (n=16)	0.749
	>3 years	263.5±317.7 (n=69)	196.6±177.0 (n=9)	0.539
Lymphadenopathy	<1 years	69.4±69.9 (n=10)	46.9±89.5 (n=42)	0.462
	1∼3 years	195.8±242.5 (n=25)	126.7±125.9 (n=43)	0.126
	>3 years	258.2±315.9 (n=54)	250.5±284.2 (n=24)	0.918
Red palm	<1 years	53.7±96.9 (n=37)	46.2±59.0 (n=15)	0.767
	1∼3 years	139.2±150.8 (n=46)	179.2±229.5 (n=22)	0.395
	>3 years	251.3±328.4 (n=44)	261.7±275.7 (n=34)	0.882
BCG	<1 years	41.8±74.6 (n=45)	111.5±130.4 (n=7)	0.045
	1∼3 years	133.3±142.0 (n=29)	166.1±203.3 (n=39)	0.459
	>3 years	140.3±138.0 (n=4)	262.1±310.4 (n=74)	0.440
CAL	<1 years	50.6±81.5 (n=8)	51.3±87.6 (n=44)	0.983
	1∼3 years	91.6±80.8 (n=11)	163.8±190.842 (n=57)	0.224
	>3 years	171.5±128.3 (n=64)	274.3±328.9 (n=14)	0.256

BCG: Bacillus Calmette-Gué rin (BCG) site redness, CAL: coronary artery lesions at 2 months after illness onset

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