Abstract
BackgroundPlatelet activation is an integral part of pathogenesis of Kawasaki disease (KD). However, there is paucity of literature on flow-cytometry based assessment of platelet activation in KD. We aimed to analyse monocyte-platelet aggregates (MPAs), one of the sensitive markers for platelet activation, by flow cytometry in children with KD.FindingsIn this single-centre prospective study, we have enrolled 14 children with KD and results were compared with age-matched febrile (n = 15) and healthy (n = 13) controls. After gating monocytes in side-scatter plot, MPAs were identified based on CD14 and CD41 expression. Two (2) ml of blood samples for children with KD were collected at 3 phases of illness- acute stage before start of intravenous immunoglobulin or aspirin, 24 h after completion of IVIg infusion, and 3 months after acute episode of KD.Children with KD had a significantly higher MPA% values [Median (IQR)- 41.3% (26.6, 52.7)] when compared with febrile [Median (IQR)- 5.98% (2.98-9.72)] and normal [Median (IQR)- 4.48% (2.57-5.59)] controls, p<0.01. On follow-up, the MPA% showed a gradual decline in children with KD, but even at 3 months, the value [Median (IQR)- 7.55% (4.15-14.6)] was higher compared to healthy controls [Median (IQR)- 4.48% (2.57-5.59)].ConclusionsOur results suggest that MPA% was significantly elevated in acute stages in children with KD and activated platelets may continue to persist even after systemic inflammation has subsided. Future studies are warranted whether objective evidence of platelet activation may guide the use of immunomodulatory and anti-platelet therapy in KD.
Highlights
Kawasaki disease (KD) is a multi-systemic vasculitis that predominantly affects young children [1]
Our results suggest that Monocyte-platelet aggregates (MPA)% was significantly elevated in acute stages in children with KD and activated platelets may continue to persist even after systemic inflammation has subsided
Future studies are warranted whether objective evidence of platelet activation may guide the use of immunomodulatory and antiplatelet therapy in KD
Summary
Kawasaki disease (KD) is a multi-systemic vasculitis that predominantly affects young children [1]. It is considered to be the most frequent cause of acquired heart disease in children in developed countries. Over 50 years have passed since Dr Tomisaku Kawasaki first reported a case series of this disease, its etiology remains unknown [1]. Prompt therapy during the acute phase of disease with intravenous immunoglobulin (IVIg) results in a marked decrease in incidence of CAAs [1]. Platelet activation is an integral part of pathogenesis of Kawasaki disease (KD). There is paucity of literature on flow-cytometry based assessment of platelet activation in KD. We aimed to analyse monocyte-platelet aggregates (MPAs), one of the sensitive markers for platelet activation, by flow cytometry in children with KD
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