Lack of effect of gamma-globulin infusion on circulating immune complexes in patients with Kawasaki syndrome

Abstract

Previous studies have demonstrated circulating immune complexes (CICs) in sera of 70% of Kawasaki syndrome (KS) patients but the pathogenic role of these complexes in the illness is unknown. Infusions of gamma-globulin (GG) have been shown recently to reduce the prevalence of coronary artery aneurysms in KS patients. One of the proposed mechanisms of action of GG therapy is through an effect on CICs. We analyzed paired sera for CICs from 29 patients with KS, 19 of whom were treated with aspirin and GG and 10 of whom received aspirin only. Assay systems used for CIC detection were Raji-mu enzyme immunoassay, C1q solid phase assay-enzyme immunoassay and F(ab')2-anti-C3-mu enzyme immunoassay. Overall 20 of 29 patients had CICs detected by at least two of three assays used. Of the 19 GG-treated patients 14 had CICs detected: 5 in both paired sera; 2 in pretherapy sera; and 7 posttherapy specimens. There was no correlation between duration of fever, presence of myocarditis or the development of coronary artery aneurysms and the presence of CICs in the serum of KS patients. Although CICs can be found frequently in the sera of KS patients there seems to be no association between the presence of CICs and the duration of fever or the development of coronary artery aneurysms.