There is marked activation of the endothelium and immune system in Kawasaki disease. Anticardiolipin antibodies (aCL) can cause activation of the endothelium. We measured aCL levels in acute Kawasaki disease patients and compared them to other febrile patients to see whether their aCL responses were different. Twenty-one patients with acute Kawasaki disease and 16 patients with an acute febrile illness were recruited. The aCL levels were measured in the sera of febrile patients and in Kawasaki disease patients prior to immunoglobulin therapy. There was no significant difference between the IgG aCL levels (p = 0.87) between the Kawasaki disease and febrile patients. However, the IgM (p = 0.01) and IgA (p = 0.03) aCL were significantly higher in patients with acute Kawasaki disease than in febrile children. Elevation of IgA aCL has been reported in association with other vasculitides and IgA-secreting plasma cells have been demonstrated in the vascular tissue in Kawasaki disease.

Keywords:
Anticardiolipin antibody, Antiphospholipid antibody, Kawasaki disease
1.
Sammaritano LR, Gharavi AE, Lockshin MD: Antiphospholipid antibody syndrome: Immunologic and clinical aspects. Semin Arthritis Rheum 1990;20:81–96.
2.
Pierangeli SS, Colden-Stanfield M, Liu X, Barker JH, Anderson GL, Harris N: Antiphospholipid antibodies from antiphospholipid syndrome patients activate endothelial cells in vitro and in vivo. Circulation 1999;99:1997–2002.
3.
Mackworth-Young C, Loizou S, Walport M: Primary antiphospholipid syndrome: Features of patients with raised anticardiolipin antibodies and no other disorder. Ann Rheum Dis 1989;48:362–367.
4.
Leung DYM, Siegel RL, Grady S, Krensky A, Meade R, Reinherz EL, Geha RS: Immunoregulatory abnormalities in mucocutaneous lymph node syndrome. Clin Immunol Immunopathol 1982;23:100–112.
5.
Leung DYM, Cotran RS, Kurt-Jones E, Burns JC, Newburger JW, Prober JS: Endothelial cell activation and high interleukin-1 secretion in pathogenesis of acute Kawasaki disease. Lancet 1989;ii:1298–1302.
6.
Fujiwara H, Hamashima Y: Pathology of the heart in Kawasaki disease. Pediatrics 1978;61:100–107.
7.
Figueroa F, Berrios X, Gutierrez M, Carrion F, Goycolea JP, Riedel I, Jacobelli S: Anticardiolipin antibodies in acute rheumatic fever. J Rheumatol 1992;19:1175–1180.
8.
Colaco CB, Mackie IJ, Irving W, Machin SJ: Anticardiolipin antibodies in viral infection. Lancet 1989;i:622.
9.
Vaarala O, Palosuo T, Kleemola M, Aho K: Anticardiolipin response in acute infections. Clin Immunol Immunopathol 1986;41:8–15.
10.
Stimmler MM, Quismorio P, McGehee WG, Boylen T, Sharma OP: Anticardiolipin antibodies in acquired immunodeficiency syndrome. Arch Intern Med 1989;149:1833–1835.
11.
Kupferwasser LI, Hafner G, Mohr-Kahaly S, Erbel R, Meyer J, Darius H: The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events. J Am Coll Cardiol 1999;33:1365–1371.
12.
Mackworth-Young CG, Harris EN, Steere AC, Rizvi F, Malawista SE, Hughes GRV, Gharavi AE: Anticardiolipin antibodies in Lyme disease. Arthritis Rheum 1988;31:1052–1056.
13.
Bayrou O, Philippoteau C, Artigou C, Haddad T, Leynadier F: Adult Kawasaki syndrome associated with HIV infection and anticardiolipin antibodies. J Am Acad Dermatol 1993;29:663–664.
14.
Vaarala O, Salo E, Pelkonen P, Palosuo T, Aho K: Anticardiolipin response in Kawasaki disease. Acta Paediatr Scand 1990;79:804–809.
15.
Ohshio G, Furukawa F, Khine M, Yoshioka H, Kudo H, Hamashima Y: High levels of IgA-containing immune complex and secretory IgA in Kawasaki disease. Microbiol Immunol 1987;31:891–898.
16.
Rowley AH, Eckerley CA, Shulman ST, Baker SC: IgA plasma cells in vascular tissue of patients with Kawasaki disease. J Immunol 1997;159:5946–5955.
17.
Rowley AH, Shulman ST, Mask CA, Finn LS, Terai M, Baker SC, Galliani CA, Takahashi K, Naoe S, Kalelkar MB, Crawford SE: IgA plasma cell infiltration of proximal respiratory tract, pancreas, kidney, and coronary artery in acute Kawasaki disease. J Infect Dis 2000;182:1183–1191.
18.
Burden AD, Tillman DM, Foley P, Holme E: IgA class anticardiolipin antibodies in cutaneous leukocytoclastic vasculitis. J Am Acad Dermatol 1996;35:411–415.
19.
Yang YH, Huang MT, Lin SC, Lin YT, Tsai MJ, Chiang BL: Increased transforming growth factor-beta (TGF-beta)-secreting cells and IgA anti-cardiolipin antibody levels during acute stage of childhood Henoch-Schönlein purpura. Clin Exp Immunol 2000;122:285–290.
20.
Tajima C, Suzuki Y, Mizushima Y, Ichikawa Y: Clinical significance of immunoglobulin A antiphospholipid antibodies: Possible association with skin manifestations and small vessel vasculitis. J Rheumatol 1998;25:1730–1736.
21.
Cunningham MW, Swerlick RA: Polyspecificity of antistreptococcal murine monoclonal antibodies and their implications in autoimmunity. J Exp Med 1986;164:998–1012.
© 2002 S. Karger AG, Basel
2002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.