Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship between vitamin D levels and intravenous immunoglobulin resistance in Kawasaki disease

  • Received : 2017.02.22
  • Accepted : 2017.05.23
  • Published : 2017.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Vitamin D is associated with various pathological conditions such as cardiovascular diseases and cancer. We investigated the relationship between vitamin D and Kawasaki disease (KD). Methods: We performed a retrospective review of the medical records of patients with KD between February 2013 and March 2016 in Daegu Fatima Hospital. Study participants were grouped according to vitamin D serum concentration. Group 1 included patients with 25(OH)-vitamin D ${\geq}20ng/mL$. Group 2 included patients with 25(OH)-vitamin D <20 ng/mL. We analyzed the clinical characteristics and laboratory data of the 2 groups. Results: Of the 91 patients, 52 were included in group 1, and 39 in group 2. Group 1 patients had significantly higher levels of calcium, phosphate, albumin and sodium than group 2 patients did. There were no differences in clinical characteristics, but the proportion of patients with polymorphic rash was significantly higher in group 2. Resistance to intravenous immunoglobulin was more frequent in group 2 (P=0.023). No significant difference in the incidence of coronary artery complications was observed. Conclusion: Low vitamin D levels are associated with resistance to intravenous immunoglobulin therapy in KD. Vitamin D deficiency might be a risk factor for immunoglobulin resistance in KD.

Keywords

References

  1. Weaver CM. Vitamin D, calcium homeostasis, and skeleton accretion in children. J Bone Miner Res 2007;22 Suppl 2:V45-9. https://doi.org/10.1359/jbmr.07s201
  2. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81. https://doi.org/10.1056/NEJMra070553
  3. Lee P. Vitamin D metabolism and deficiency in critical illness. Best Pract Res Clin Endocrinol Metab 2011;25:769-81. https://doi.org/10.1016/j.beem.2011.03.001
  4. Hwang YC, Ahn HY, Jeong IK, Ahn KJ, Chung HY. Optimal serum concentration of 25-hydroxyvitamin D for bone health in older Korean adults. Calcif Tissue Int 2013;92:68-74. https://doi.org/10.1007/s00223-012-9669-3
  5. WHO Scientific group on the prevention and management of osteoporosis. Prevention and management of osteoporosis: report of a WHO scientific group: Geneva: World Health Organization, 2003.
  6. Yang HR, Seo JW, Kim YJ, Kim JY, Ryoo E, Sim JG, et al. Recent concepts on vitamin D in children and adolescents. Korean J Pediatr 2009;52:1082-9. https://doi.org/10.3345/kjp.2009.52.10.1082
  7. Choi CH, Byun SH, Jeon JD, Choi JW. Usefulness of echocardiographic findings in the early diagnosis of Kawasaki disease. Korean J Pediatr 2007;50:47-51. https://doi.org/10.3345/kjp.2007.50.1.47
  8. Kunadian V, Ford GA, Bawamia B, Qiu W, Manson JE. Vitamin D deficiency and coronary artery disease: a review of the evidence. Am Heart J 2014;167:283-91. https://doi.org/10.1016/j.ahj.2013.11.012
  9. Lavie CJ, Lee JH, Milani RV. Vitamin D and cardiovascular disease will it live up to its hype? J Am Coll Cardiol 2011;58:1547-56. https://doi.org/10.1016/j.jacc.2011.07.008
  10. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 2004;114:1708-33. https://doi.org/10.1542/peds.2004-2182
  11. Research Committee on Kawasaki Disease. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo, Japan: Ministry of Health and Welfare, 1984.
  12. de Zorzi A, Colan SD, Gauvreau K, Baker AL, Sundel RP, Newburger JW. Coronary artery dimensions may be misclassified as normal in Kawasaki disease. J Pediatr 1998;133:254-8. https://doi.org/10.1016/S0022-3476(98)70229-X
  13. Hirao J, Hibi S, Andoh T, Ichimura T. High levels of circulating interleukin-4 and interleukin-10 in Kawasaki disease. Int Arch Allergy Immunol 1997;112:152-6. https://doi.org/10.1159/000237447
  14. Wallace CA, French JW, Kahn SJ, Sherry DD. Initial intravenous gammaglobulin treatment failure in Kawasaki disease. Pediatrics 2000;105:E78. https://doi.org/10.1542/peds.105.6.e78
  15. Durongpisitkul K, Soongswang J, Laohaprasitiporn D, Nana A, Prachuabmoh C, Kangkagate C. Immunoglobulin failure and retreatment in Kawasaki disease. Pediatr Cardiol 2003;24:145-8. https://doi.org/10.1007/s00246-002-0216-2
  16. Kobayashi T, Inoue Y, Takeuchi K, Okada Y, Tamura K, Tomomasa T, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation 2006;113: 2606-12. https://doi.org/10.1161/CIRCULATIONAHA.105.592865
  17. Park HM, Lee DW, Hyun MC, Lee SB. Predictors of nonresponse to intravenous immunoglobulin therapy in Kawasaki disease. Korean J Pediatr 2013;56:75-9. https://doi.org/10.3345/kjp.2013.56.2.75
  18. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet 1998;352:709-10.
  19. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-11. https://doi.org/10.1161/CIRCULATIONAHA.107.706127
  20. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, et al. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med 2008;168:1340-9. https://doi.org/10.1001/archinte.168.12.1340
  21. Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 2005;94:483-92. https://doi.org/10.1079/BJN20051544
  22. Verdoia M, Schaffer A, Barbieri L, Di Giovine G, Marino P, Suryapranata H, et al. Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Nutr Metab Cardiovasc Dis 2015;25:464-70. https://doi.org/10.1016/j.numecd.2015.01.009
  23. Lee A, Kim SH, Nam CM, Kim YJ, Joo SH, Lee KR. Prevalence of Vitamin D Deficiency and insufficiency in Korean children and adolescents and associated factors. Lab Med Online 2016;6:70-8. https://doi.org/10.3343/lmo.2016.6.2.70
  24. Terai M, Yasukawa K, Narumoto S, Tateno S, Oana S, Kohno Y. Vascular endothelial growth factor in acute Kawasaki disease. Am J Cardiol 1999;83:337-9. https://doi.org/10.1016/S0002-9149(98)00864-9
  25. Ben-Shoshan M, Amir S, Dang DT, Dang LH, Weisman Y, Mabjeesh NJ. 1alpha,25-dihydroxyvitamin D3 (Calcitriol) inhibits hypoxiainducible factor-1/vascular endothelial growth factor pathway in human cancer cells. Mol Cancer Ther 2007;6:1433-9.
  26. Irani M, Seifer DB, Grazi RV, Irani S, Rosenwaks Z, Tal R. Vitamin D decreases serum VEGF correlating with clinical improvement in vitamin D-deficient women with PCOS: a randomized placebo-controlled trial. Nutrients 2017;9(4). pii: E334. https://doi: org/ 10.3390/nu9040334.
  27. Lim GW, Lee M, Kim HS, Hong YM, Sohn S. Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion in kawasaki disease. Korean Circ J 2010;40:507-13. https://doi.org/10.4070/kcj.2010.40.10.507
  28. Passeri E, Rigolini R, Costa E, Verdelli C, Arcidiacono C, Carminati M, et al. Serum NT-proBNP levels are not related to vitamin D status in young patients with congenital heart defects. Dis Markers 2016:Article ID 3970284.
  29. Stagi S, Rigante D, Lepri G, Matucci Cerinic M, Falcini F. Severe vitamin D deficiency in patients with Kawasaki disease: a potential role in the risk to develop heart vascular abnormalities? Clin Rheumatol 2016;35:1865-72. https://doi.org/10.1007/s10067-015-2970-6

Cited by

  1. Breastfeeding and vitamin D supplementation reduce the risk of Kawasaki disease in a German population-based case-control study vol.19, pp.1, 2017, https://doi.org/10.1186/s12887-019-1438-2
  2. Possible role of vitamin D in Covid-19 infection in pediatric population vol.44, pp.1, 2021, https://doi.org/10.1007/s40618-020-01327-0
  3. Phenotype, Susceptibility, Autoimmunity, and Immunotherapy Between Kawasaki Disease and Coronavirus Disease-19 Associated Multisystem Inflammatory Syndrome in Children vol.12, pp.None, 2017, https://doi.org/10.3389/fimmu.2021.632890
  4. Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C) vol.12, pp.None, 2017, https://doi.org/10.3389/fimmu.2021.648546