Analysis of Kawasaki disease showing elevated antibody titres of Yersinia pseudotuberculosis

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Abstract
Aim: To elucidate a clinical difference between patients with Kawasaki disease documented with Yersinia pseudotuberculosis infection and patients with Kawasaki disease without Yersinia pseudotuberculosis infection. Patients and methods: From January 1985 to July 2004, 452 patients were diagnosed with Kawasaki disease. Forty‐two patients had elevated antibody titres of Yersinia pseudotuberculosis and/or positive stool culture (Yersinia‐positive group). Three hundred and thirty patients had no elevated antibody titres (Yersinia‐negative group). We compared the clinical characteristics retrospectively. Results: The age of onset in the Yersinia‐positive group (3.05±2.20 y) was significantly higher than that in the Yersinia‐negative group (2.31±2.05 y) (p=0.03). The age‐adjusted statistical analysis demonstrated that the incidence of coronary artery lesions (dilatations plus aneurysms) in the Yersinia‐positive group (22/42, 52.4%) was significantly higher than in the Yersinia‐negative group (105/330, 31.8%) (p=0.001), and the incidence of additional administration of immunoglobulin in the Yersinia‐positive group (13/36, 36.1%) was significantly higher than in the Yersinia‐negative group (41/256, 16.0%) (p=0.004). Conclusion: Our data suggest that Yersinia pseudotuberculosis infection might play a role in the developing mechanism of poor response to therapy and the tendency to develop coronary artery lesions in Kawasaki disease patients.