PMID- 26561332
OWN - NLM
STAT- MEDLINE
DCOM- 20160628
LR  - 20181113
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 15
DP  - 2015 Nov 11
TI  - Yersinia pseudotuberculosis infection in Kawasaki disease and its clinical 
      characteristics.
PG  - 177
LID - 10.1186/s12887-015-0497-2 [doi]
LID - 177
AB  - BACKGROUND: The 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. METHODS: We 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). RESULTS: Eleven 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). CONCLUSIONS: 
      KD 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.
FAU - Horinouchi, Tomoko
AU  - Horinouchi T
AD  - Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, 
      Japan. tomoko.hatono@gmail.com.
FAU - Nozu, Kandai
AU  - Nozu K
AD  - Department of Pediatrics, Kobe University Hospital, Kobe, Japan. 
      nozu@med.kobe-u.ac.jp.
FAU - Hamahira, Kiyoshi
AU  - Hamahira K
AD  - Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, 
      Japan. hamahira68@hotmail.com.
FAU - Inaguma, Yosuke
AU  - Inaguma Y
AD  - Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, 
      Japan. yinaguma0709@yahoo.co.jp.
FAU - Abe, Jun
AU  - Abe J
AD  - Department of Allergy and Immunology, National Research Institute for Child 
      Health and Development, Tokyo, Japan. abe-j@ncchd.go.jp.
FAU - Nakajima, Hiroshi
AU  - Nakajima H
AD  - Department of Bacteriology, Okayama Prefectural Institute for Environmental 
      Science and Public Health, Okayama, Japan. hiroshi_nakajima@pref.okayama.lg.jp.
FAU - Kugo, Masaaki
AU  - Kugo M
AD  - Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, 
      Japan. m.kugo@hrc-hp.com.
FAU - Iijima, Kazumoto
AU  - Iijima K
AD  - Department of Pediatrics, Kobe University Hospital, Kobe, Japan. 
      iijima@med.kobe-u.ac.jp.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20151111
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - 0 (Antibodies, Bacterial)
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Antibodies, Bacterial/analysis
MH  - Child, Preschool
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/administration & dosage
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage
MH  - Immunologic Factors/administration & dosage
MH  - Infant
MH  - Male
MH  - Methylprednisolone/*administration & dosage
MH  - Mucocutaneous Lymph Node Syndrome/drug therapy/*etiology
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Yersinia pseudotuberculosis/immunology
MH  - Yersinia pseudotuberculosis Infections/*complications/drug therapy/microbiology
PMC - PMC4642785
EDAT- 2015/11/13 06:00
MHDA- 2016/06/29 06:00
PMCR- 2015/11/11
CRDT- 2015/11/13 06:00
PHST- 2014/11/10 00:00 [received]
PHST- 2015/10/23 00:00 [accepted]
PHST- 2015/11/13 06:00 [entrez]
PHST- 2015/11/13 06:00 [pubmed]
PHST- 2016/06/29 06:00 [medline]
PHST- 2015/11/11 00:00 [pmc-release]
AID - 10.1186/s12887-015-0497-2 [pii]
AID - 497 [pii]
AID - 10.1186/s12887-015-0497-2 [doi]
PST - epublish
SO  - BMC Pediatr. 2015 Nov 11;15:177. doi: 10.1186/s12887-015-0497-2.