Abstract
A previous study on Kawasaki Disease (KD) revealed an interesting new marker to monitor disease activity: human neutrophil elastase (HNE). HNE is released by granulocytes, and their plasma levels are a good representation of the activity of those cells in vivo. Materials and Methods: A cohort of patients was screened prospectively. Blood was collected at sequential time-points, starting before IVIG administration. We determined plasma HNE and CRP, as routine inflammatory marker, by ELISA. Results: Preliminary data showed an increase of HNE levels in all KD patients in the acute phase of the disease. These levels remained high for a period of weeks only slowly returning to normal. Levels of HNE were 1155 ng/ml [95% C.I.: 703-1607 ng/ml] before IVIG administration. After 1 week, 6 weeks and 3 months the levels were 475 ng/ml [95% C.I.: 210-740 ng/ml], 300 ng/ml [95% C.I.: 158-442 ng/ml] and 386 ng/ml [95% C.I.: 69-702 ng/ml] respectively. Levels below 50 ng/ml are considered normal for children. Levels of CRP were only elevated until 1 week thereafter: 113 mg/L [95% C.I.: 70-157 mg/L] and 25 ng/ml [95% C.I.: 6.7-44 mg/L] respectively. After 6 weeks and 3 months the levels had normalized: 2.3 mg/L [95% C.I.: 0.1-4.8 mg/L] and 2.7 ng/ml [95% C.I.: 0.1-5.9 mg/L] (Normal value <5.0 mg/L). Conclusion: Human neutrophil elastase appears to be useful to monitor the acute phase of the disease activity. This finding indicates that inflammation proceeds for a longer period than has been suggested previously. A relation between prolonged inflammation and premature atherosclerosis warrants further evaluation.
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Biezeveld, M., Kuipers, I., Newburger, J. et al. A Novel Marker for Disease Activity in Kawasaki Disease. Pediatr Res 53, 172 (2003). https://doi.org/10.1203/00006450-200301000-00111
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DOI: https://doi.org/10.1203/00006450-200301000-00111