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KMID : 0368120210510030267
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Korean Circulation Journal
2021 Volume.51 No. 3 p.267 ~ p.278
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IgA Levels Are Associated with Coronary Artery Lesions in Kawasaki Disease
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Kim Jae-Jung
Kim Hea-Ji
Yu Jeong-Jin
Yun Sin-Weon
Lee Kyung-Yil
Yoon Kyung-Lim
Kil Hong-Ryang
Kim Gi-Beom
Han Myung-Ki
Song Min-Seob
Lee Hyoung-Doo
Jun Hyun-Ok
Ha Kee-Soo
Hong Young-Mi
Jang Gi-Young
Lee Jong-Keuk
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Abstract
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Background and Objectives: Kawasaki disease (KD) is an acute systemic vasculitis that affects the coronary arteries. Abnormal immune reactions are thought to contribute to disease pathogenesis. The effect of immunoglobulin (Ig) isotype (IgG, IgA, IgM, and IgE) on inflammatory data and clinical outcomes of patients with KD was examined.
Methods: Ig levels in 241 patients with KD were measured during the acute, subacute, convalescent, and normal phases of the disease.
Results: Compared with reference Ig values, IgG, IgA, and IgM levels were significantly higher in the subacute phase, while IgE levels were elevated in 73.9% (178/241) of patients with KD in all clinical phases. However, high IgE levels were not associated with clinical outcomes, including intravenous immunoglobulin unresponsiveness and coronary artery lesions (CALs). Significantly more CALs were observed in the high IgA group than in the normal IgA group (44.7% vs. 20.8%, respectively; p<0.01). In addition, IgA levels in the acute phase (p=0.038) were 2.2-fold higher, and those in the subacute phase were 1.7-fold higher (p <0.001), in the CAL group than in the non-CAL group. IgA concentrations increased along with the size of the coronary artery aneurysm (p <0.001). Furthermore, there was a strong correlation between IgA levels and CAL size (r=0.435, p<0.001), with a high odds ratio of 2.58 (p=0.022).
Conclusions: High IgA levels in patients with KD are prognostic for the risk of CALs.
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KEYWORD
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Mucocutaneous lymph node syndrome, IgA, Coronary aneurysms
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