Immunologic abnormalities in children with acute Kawasaki disease.

Spontaneous release of IgG, production of IgG, IgM and IgG subclasses induced by PWM in vitro, serum IgG, IgM, IgA and IgG subclasses were measured in 23 patients with acute Kawasaki disease (KD). The results showed that there was polyclonal B cell activation with significantly increased IgG1 and IgG3. As compared with 21 healthy controls, the mean activities of B cell growth factors (BCGFs), B cell differentiation factors (BCDFs) and interleukin 6 (IL-6) were significantly elevated. IL-6 activity was correlated with the production of IgG, IgG1, IgG3 and IgM, while BCGFs and BCDFs were also correlated with IgG1. The serum level of circulating tumor necrosis factor (TNF) determined in 16 patients with acute KD using double antibody ELISA was 1.86-8.83 micrograms/ml, but it was less than 1 microgram/L in normal controls. The clinical value of increased TNF in serum is discussed.