All issues > Volume 35(4); 1992

Original Article

J Korean Pediatr Soc. 1992;35(4):515-526. Published online April 15, 1992.

The Interleukin-6 Level in Kawasak Disease

Moon Kyu MK Kim¹, Dong Soo DS Kim¹

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea

Abstract

Kawasaki disease is an acute multisystemic disease affecting infants and children with prominent vasculitic features. Although there has been considerable progress in understanding the pathogenesis of this disease, the inciting cause remains unclear. It has been noticed that there were many immunologic abnormalities during the acute stage of Kawasaki disease. In the pres-ent study, we studied serum interleukin-6(IL-6), C-reactive protein(CRP), circulating immune c-omplex(CIC) and tumor necrosis factor-α(TNF-α) level, and tried to investigate their relationship with the clinical manifestations of in Kawasaki disease. The subjects consisted of 50 patients with Kawasaki disease, 14 patients with viral infections, 18 normal children, who were admitted to Severance hospital and So-Hwa children's hospital from September, 1988 to July, 1990. All the sera were kept in deep freezer at -70℃ until use. The serum IL-6 level was measured by sandwitch ELISA method(Fujirebio Inc., Tokyo, Jap-an), the serum CRP level by fluorescence polarization immunoassay(TDx: Abbott Inc.), the serum CIC level by solid phase C1q binding assay(Cappel: Cappel Laboratories, Malvern, Pa.) and the serum TNF-α level by immunoradiometric assay(Medgenix, Brussel, Belgium). The results were as follows; In Kawasaki disease, the mean of serum IL-6 level markedly increased to 136.9pg/ml at acute stage and decreased to 21.9pg/mI at convalescent stage. The serum CRP level was 13.9 mg/dl at acute stage and decreased to 2.0mg/dl at convalescent stage. The normal ranges of serum IL-6 and serum CRP were below 5.0pg/ml and 1.0mg/dl respectively in this study. The serum TNF-α level was 14.5pg/ml at acute stage and decreased to 7.6pg/ml at convalescent stage. In the patients with viral infections, the serum IL-6 and CRP level were increased to 17.9 pg/mI and 1.9mg/dI, respectively, in acute stage which is less remarkable than those of Kawasaki disease. The IgG-CIC were within normal limits in both acute and convalescent stages of Kawasaki disease. There was a significant correlation between IL-6 and CRP in Kawasaki disease. Thirty-two out of 50 patients with Kawasaki disease were treated with intravenous immunoglobulin at acute stage of the illness. It is interesting to note that there was a significant corr-elation between the serum IL-6 level at acute stage and the fever duration. But there was no correlation between the serum IL-6 level at acute stage and the peak platelet count. The source and the mechanism which increase serum IL-6 level in Kawasaki disease remains obscure and further studies should be conducted.

Keywords :Kawasaki disease, Interleukin-6