Soluble forms of the selectin family in children with Kawasaki disease: prediction for coronary artery lesions

Aim : To investigate the relationship between the plasma levels of soluble forms of the selectin family and the incidence of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods : Thirty‐three patients with KD, including group A patients ( n = 22) who had no CALs and group B patients ( n = 11) who had CALs, as well as age‐matched febrile ( n = 10) and afebrile controls ( n = 11), were studied. Results : Peak plasma E‐selectin levels (172.0 ± 58.6 ng ml ‐1 ) occurred during the acute phase of KD, while peak plasma P‐selectin levels (260.3 ± 43.2 ng ml ‐1 ) occurred during the subacute phase of the illness ( p ± 0.05). Plasma L‐selectin levels (1757.3 ± 244.3 ng ml ‐1 ) during the convalescent phase tended to be higher than in either the acute or the subacute phase (not significant). Before intravenous immunoglobulin treatment, the plasma levels of E‐ (225.1 ± 46.8 ng ml ‐1 ) and P‐selectin (259.4 ± 76.2 ng ml ‐1 ) of patients with CALs ( n = 11) were significantly higher than those of patients ( n = 22) with no CALs (E‐selectin, 131.6 ± 36.9 ng ml ‐1 ; P‐selectin, 184.9 ± 84.6 ng ml ‐1 ; p ± 0.05). When a plasma E‐selectin value before immunoglobulin treatment of ± 184.7 ng ml ‐1 was used as the cut‐off point, the sensitivity and specificity for the incidence of CALs were 81.8% and 90.9%, respectively. These findings demonstrate the relationship between plasma levels of selectins and disease severity of Kawasaki vasculitis. Conclusion : Higher plasma levels of E‐selectin may have potential as a predictor of the incidence of coronary artery lesions in Kawasaki disease patients.