TNF-? Is Superior To Conventional Inflammatory Mediators In Forecasting IVIG Nonresponse And Coronary Arteritis In Chinese Patients With Kawasaki Disease

ObjectiveTumor necrosis factor(TNF)-? is of inflammatory cytokines produced chiefly by activated monocyte/macrophages,and has been implicated in the pathogenesis of kawasaki disease(KD).We elucidated the relationship of plasma TNF-? with conventional inflammatory mediators,clinical classification,intravenous immunoglobulin(IVIG)response and coronary arteritis in the course of KD.conventional inflammatory mediators,clinical classification,intravenous.MethodsSeventy Chinese children with KD were enrolled and divided into 6 subgroups,including complete KD,incomplete KD,IVIG-responsive KD,IVIG-nonresponsive KD,coronary artery(CA)-noninvolvement KD and CA-involvement KD.Blood samples were collected from all subjects at 24 h pre-and 48 h post-IVIG therapy,respectively.TNF-?,white blood cells counts(WBC),absolute neutrophil counts(ANC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and procalcitonin(PCT)were detected.ResultsPlasma TNF-? markedly increased in the acute phase of KD and was positively correlated with CRP and PCT,whereas remained high after IVIG therapy.TNF-? as well as conventional inflammatory mediators could not be used to differentiate the clinical classification of KD,but they may prove beneficial to heighten or reduce the suspicion of incomplete KD.Plasma TNF-? was significantly higher in both IVIG-nonresponsive patients and coronary arteritis patients,but no significant differences were observed in all the other inflammatory mediators.Moreover,plasma TNF-? was positively correlated with the internal diameter of CA.ConclusionTNF-? is superior to conventional inflammatory mediators in forecasting IVIG nonresponse and coronary arteritis in Chinese children with KD.