Abstract 63: Evaluation Of The Immune Dynamics Of Kawasaki Disease

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Abstract

Background: We investigated immune function in Kawasaki diseas(KD)patints during the acute phase , 1 month aftr onset , 6 months after onset and 9 months after onset.

Methods: All patients treated with 2g/kg of Intravenous immunoglobulin (single IVIG) or 4g/kg of IVIG(additional IVIG). We enrolled 18 KD patients(age,4 to 90 months).IgG,IgM,IgA,IgD,B-cell surface immunoglobulin(Sm-Ig),CD3,CD4,CD8,CD20,CD56 were measured using flow cytometry;the lymphocyte transformation test(LTT)was also performed.In addition,migration of IVIG antibodies was assessed,and measles,rubella,mumps,and chickenpox antibodies were investigated using enzyme immunoassay(EIA).

Results: IgG at 1 month after KD onset was significantly higher than before IVIG treatment. In addition, the number of the lymphocytes at 1 month after KD onset was higher than before IVIG treatment.. The valus for Sm-Ig IgM,Sm-Ig IgD,Sm-Ig κ,and Sm-Ig λ before IVIG treatment was higher than those at 1 month after KD onset. In addition, The valus for CD8 before IVIG treatment was higher than those at 1 month after KD onset. The values for CD3,CD4 before IVIG treatment was lower then those at 1 month after KD onset. The values for CD8 was higher at 1 month after KD onset. The levels of measles,rubella,mumps,and chickenpox antibodies were positive at 1 month after single IVIG treatment and these antibodies were negative at 6 months after single IVIG treatment. The levels of measles,rubella,mumps,and chickenpox antibodies were positive at 1 month after additional IVIG treatment. These antibodies were still positive in some of patient at 6 month after additional IVIG treatment,but negative at 9 months after additional IVIG treatment.

Conclusions: Abnormal immune function at KD onset may improve at 1month after KD. onset.We can vaccinate children at least 2 month after KD onset. However it is recommended that live vaccines be deferred for at least 6 months following treatment with single IVIG ,and 9 months following treatment with additional IVIG.

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