This document summarizes a study on eosinophils and their association with Kawasaki disease (KD) and response to intravenous immunoglobulin (IVIG) treatment. Eosinophil levels were higher in patients with KD compared to controls and decreased after successful IVIG treatment. Eosinophil levels positively correlated with levels of the Th2 cytokine IL-5 but not eosinophil cationic protein. Patients without coronary artery abnormalities after treatment had higher eosinophil and IL-5 levels after IVIG compared to those with abnormalities. This suggests eosinophils may be a predictor of treatment response and prognosis in KD.

1. 郭和昌 于鴻仁 王 玲 吳自強 醫師 楊崑德 教授 高雄長庚醫院 兒童過敏免疫風濕科 長庚大學臨研所 Feb 14, 2008

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5. 臨床表現特點 ( 診斷要件 ) Kuo et al. Acta Pediatr Twiwan . 2006;47(suppl):7-17.

6. Kawasaki Disease- 後天性心臟病之主因 Involved small and medial size vessel Coronary artery aneurysm

11. Delay diagnosis of KD Pediatrics 2005;115;428-433 >10 days High risk of CAL J Chin Med Assoc. 2007;70:374-9. ( 北榮 , N=14/78)

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14. CMV bocavirus 川崎氏症是否為感染性疾病？ Kuo et al. Acta Pediatr Twiwan . 2006;47(suppl):7-17.

15. Wang and Kuo et al. Pediatr Infect Dis J 2005;24:998–1004. 曾被報告過與川崎氏症有關的基因多型性

17. Nat Genet . 2008;40:35-42. ITPKC and NFAT in KD

19. Circulation 2004;110;2747-2771 Differential Diagnosis of KD

22. Infection and KD Pediatrics 2005;116;e760-e766 Diagnosis of KD  start IVIG Tx  stop antibiotics ?

25. N Engl J Med 2007;356:663-75. MP pulse in KD

26. MP pulse in KD Wang CL et al. J Microbiol Immunol Infect. 2005. J Pediatr 2003;143:363-7

28. 百萬夜景

32. CAL- timing Arch Pediatr Adolesc Med. 2006;160:686-90.

34. Prognosis - role of eosinophil Kuo et al. Pediatr Allergy Immunol 2007 In revision: Pediatr Allergy Immunol

35. May different brands of IVIG affect the eosinophil counts in KD ? Kuo et al. Pediatr Allergy Immunol 2008;19:184-5.

38. Pediatr Res 2008;63: 207–210.

40. In revision: Pediatr Allergy Immunol (SCI IF:2.849, rank 7/74)

42. Analysis of CBC/DC in KD and Controls Student’s t- test 0.61 0.21 ± 0.05 0.17 ± 0.03 Basophil (%) < 0.01 0.4 ± 0.1 2.4 ± 0.2 Eosinophil (%) 0.20 6.8 ± 0.7 5.7 ± 0.3 Monocyte (%) 0.31 27.5 ± 2.5 24.6 ± 1.2 Lymphocyte (%) 0.23 62.4 ± 2.7 65.9 ± 1.4 Neutrophil (%) < 0.01 26.4 ± 1.1 37.6 ± 1.4 Platelet (×10 4 /mm 3 ) < 0.01 12.2 ± 0.1 10.8 ± 0.1 Hemoglobin (g/dL) < 0.01 9412 ± 551 13792 ± 733 Total leukocyte/mm 3 P values Control (N = 30) KD (N = 95)

43. Eosinophil increase in acute KD and inverse correlation with IVIG resistant Kuo and Yang et al. Pediatr Allergy Immunol 2007;18:354–359.

44. Levels of eosinophil-related Th2 cytokines and ECP were higher in KD Control: upper respiratory track infection, student t test. <0.001 2.98±0.23 10.9±1.71 ECP (pg/ml) <0.001 2.65±0.55 5.17±0.56 IL-5 (pg/ml) 0.004 74.52±7.45 116.7±12.5 Eotaxin (pg/ml) <0.001 5.96±0.54 12.07±1.36 IL-4 (pg/ml) P value Control (N=30) KD (N=95)

45. Changes of eosinophil-related Th2 cytokine and ECP after IVIG treatment

46. Changes of eosinophils positively correlated with IL-5 but not ECP Eosinophil vs. IL-5 Eosinophil vs. ECP

47. Mann-Whitney U test Eosinophils and IL-5 after IVIG treatment were significantly higher in KD without CAL

49. Deadline for Submission: Jan 15, 2007

50. Abstracts submitted to 9th KD symposium till Jan 15, 2008

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54. Thanks a lot for your attention and comment !!!