The Study of Serum Vascular Endothelial Growth Factor in the Acute Febrile Phase of Kawasaki Disease

ABSTRACT

PURPOSE: Kawasaki Disease(KD) is a febrile disease with acute multisystemic vasculitis associated with early development of acute myocarditis and coronary artery abnormalities. The cause and etiologic agents are still unknown. Clinical studies suggest that KD is one of the autoimmune disorders caused by infectious agent, but this is not proved yet. The study was performed to investigate the levels of vascular endothelial growth factor(VEGF) in the acute stage of KD before treatment of intravenous-gammaglobulin(IVGG) to confirm and find an early diagnostic method of vasculitis by serologic test. METHODS: The patient group consisted of 61 cases in acute stages of KD before treatment of IVGG who were hospitalized from Jan. 1998 to Feb. 2001. The control group consisted of 24 cases among the admitted cases who suffered from non KD. The levels of VEGF in the obtained sera were measured by using chemoluminoimmunoassay, and those of both groups were compared to each other. RESULTS: The sex ratio of male to female was 1.6:1, males were more prone to infection, and mean age was 2.6+/-1.6 years old. The levels of VEGF in patients group(143.64+/-115.38 pg/mL) were significantly increased as compared with control group(26.55+/-13.75 pg/mL)(P<0.05). One case of acute myocarditis and two cases of left coronary artery dilations occurred in the patient group, but they all recovered after treatment two months later. Acute phage reactants such as CRP, ESR were positive and WBC was increased in acute stages of both groups. CONCLUSION: The significant increasing level of serum VEGF in acute febrile stages of KD suggests that acute vasculitis began in the early stage in all of the patients group, and the measurement of VEGF can be one of useful method for early diagnosis of vasculitis in KD. This may be helpful in early IVGG treatment of the condition.