Browse > Article
http://dx.doi.org/10.3345/kjp.2009.52.11.1241

Association between Kawasaki disease and acute respiratory viral infections  

Cho, Eun Young (Department of Pediatrics, Seoul National University College of Medicine)
Eun, Byung Wook (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Kim, Nam Hee (Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital)
Lee, Jina (Department of Pediatrics, Seoul National University College of Medicine)
Choi, Eun Hwa (Department of Pediatrics, Seoul National University College of Medicine)
Lee, Hoan Jong (Department of Pediatrics, Seoul National University College of Medicine)
Choi, Jung Yun (Department of Pediatrics, Seoul National University College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.52, no.11, 2009 , pp. 1241-1248 More about this Journal
Abstract
Purpose:The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections. Methods:Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children's Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively. Results:The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P>0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05). Conclusion:Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.
Keywords
Kawasaki disease; Respiratory tract infections; Human coronavirus;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Rowley AH, Shulman ST. Kawasaki syndrome. Clin Microbiol Rev 1998;11:405-14   PUBMED   ScienceOn
2 Lee JA, Kim NH, Kim SJ, Choi EH, Lee HJ. Rapid identification of human adenovirus types 3 and 7 from respiratory specimens via multiplex type-specific PCR. J Clin Microbiol 2005;43: 5509-14   DOI   ScienceOn
3 Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005. Clin Infect Dis 2006;43:585-92   DOI   ScienceOn
4 Research Committee on Kawasaki Disease. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo, Japan: Ministry of Health and Welfare 1984
5 Cha SH. Pathogenesis of Kawasaki disease. Korean J Pediatr Infect Dis 2007;14:6-16
6 Leung DY, Sullivan KE, Brown-Whitehorn TF, Fehringer AP, Allen S, Finkel TH, et al. Association of toxic shock syndrome toxin-secreting and exfoliative toxin-secreting Staphylococcus aureus with Kawasaki syndrome complicated by coronary artery disease. Pediatr Res 1997;42:268-72   DOI   ScienceOn
7 Burns JC, Kushner HI, Bastian JF, Shike H, Shimizu C, Matsubara T, et al. Kawasaki disease: A brief history. Pediatrics 2000;106:E27   DOI   ScienceOn
8 Shimizu C, Shike H, Baker SC, Garcia F, van der Hoek L, Kuijpers TW, et al. Human coronavirus NL63 is not detected in the respiratory tracts of children with acute Kawasaki disease. J Infect Dis 2005;192:1767-71   DOI   ScienceOn
9 Park YW, Han JW, Park IS, Kim CH, Cha SH, Ma JS, et al. Kawasaki disease in Korea, 2003-2005. Pediatr Infect Dis J 2007;26:821-3   DOI   ScienceOn
10 Johnson D, Azimi P. Kawasaki disease associated with Klebsiella pneumoniae bacteremia and parainfluenza type 3 virus infection. Pediatr Infect Dis 1985;4:100
11 Takahashi K, Oharaseki T, Wakayama M, Yokouchi Y, Naoe S, Murata H. Histopathological features of murine systemic vasculitis caused by Candida albicans extract-an animal model of Kawasaki disease. Inflamm Res 2004;53:72-7   DOI   ScienceOn
12 Rowley AH, Baker SC, Shulman ST, Garcia FL, Guzman- Cottrill JA, Chou P, et al. Detection of antigen in bronchial epithelium and macrophages in acute Kawasaki disease by use of synthetic antibody. J Infect Dis 2004;190:856-65   DOI   ScienceOn
13 Ebihara T, Endo R, Ma X, Ishiguro N, Kikuta H. Lack of association between New Haven coronavirus and Kawasaki disease. J Infect Dis 2005;192:351-2   DOI   ScienceOn
14 Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110: 2747-71   DOI   ScienceOn
15 Rowley AH, Eckerley CA, J$\ddot{a}$ck HM, Shulman ST, Baker SC. IgA plasma cells in vascular tissue of patients with Kawasaki syndrome. J Immunol 1997;159:5946-55
16 Lehmann C, Klar R, Lindner J, Lindner P, Wolf H, Gerling S. Kawasaki disease lacks association with human coronavirus NL63 and human bocavirus. Pediatr Infect Dis J 2009;28:553-4   DOI   ScienceOn
17 Shike H, Shimizu C, Kanegaye JT, Foley JL, Schnurr DP, Wold LJ, et al. Adenovirus, adeno-associated virus and Kawasaki disease. Pediatr Infect Dis J 2005;24:1011-4   DOI   ScienceOn
18 Esper F, Shapiro E, Weibel C, Ferguson D, Landry M, Kahn J. Association between a novel human coronavirus and Kawasaki disease. The Journal of Infectious Diseases 2005;191:499-502   DOI   ScienceOn
19 Usui D, Ishii Y, Akaike H, Isumi H, Komura H, Kawasaki K, et al. Yersinia pseudotuberculosis type 4a infection meeting the diagnostic criteria for Kawasaki disease complicated by disseminated intravascular coagulation. Kansenshogaku Zasshi 2005;79: 895-9   DOI   PUBMED
20 Culora GA, Moore IE. Kawasaki disease, Epstein-Barr virus and coronary artery aneurysms. J Clin Pathol 1997;50:161-3   DOI   ScienceOn
21 Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi 1967;16:178-222   PUBMED
22 Bell DM, Brink EW, Nitzkin JL, Hall CB, Wulff H, Berkowitz ID, et al. Kawasaki syndrome: description of two outbreaks in the United States. N Engl J Med 1981;304:1568-75   DOI   PUBMED   ScienceOn
23 Nigro G, Zerbini M, Krzysztofiak A, Gentilomi G, Porcaro MA, Mango T, et al. Active or recent parvovirus B19 infection in children with Kawasaki disease. Lancet 1994;343:1260-1   DOI   ScienceOn
24 Dominguez SR, Anderson MS, Glodé MP, Robinson CC, Holmes KV. Blinded case-control study of the relationship between human coronavirus NL63 and Kawasaki syndrome. J Infect Dis 2006;194:1697-701   DOI   ScienceOn
25 Matsubara K, Fukaya T. The role of superantigens of group A Streptococcus and Staphylococcus aureus in Kawasaki disease. Curr Opin Infect Dis 2007;20:298-303   DOI   ScienceOn
26 Khono T, Takase Y, Niki H. Chlamydia infections in Kawasaki disease. Acta Paediatr Jpn 1991;33:408-10   DOI   ScienceOn