Article in Japanese

A case of Kawasaki disease elevated serum IL-1β before the onset of arthritis

Yuka OHASHI^1）, Hidetaka NAKAI^1）, Kei KOZAWA^2）, Yoshiki KAWAMURA^3）, Tetsushi YOSHIKAWA^2）

Kawasaki disease (KD) is the cause of various symptoms not only in the coronary artery but also multiple organs. It rarely causes arthritis, and in such cases, it is important to distinguish between juvenile idiopathic arthritis, pyogenic arthritis, and osteonecrosis of the femoral head. Although the etiology of KD remains unclear, excessive immune response such as overproduction of inflammatory cytokines that induces systemic vasculitis has been speculated, and more than 30 serum cytokines have been analyzed in the past. However, no reports have analyzed cytokines over time in KD with arthritis. This study measured various cytokines at multiple points retrospectively in patients with hip arthritis during the recovery phase of KD. The results showed that interleukin (IL)-1β was elevated before the onset of joint pain. Other diseases, such as pyogenic arthritis, were ruled out by various exams, and this study diagnosed KD with arthritis. Therefore, analyzing IL-1β may be useful in predicting arthritis and discovering the pathological mechanism in KD. The authors will study KD with arthritis and differential diseases such as pyogenic arthritis further, for elucidating the pathogenesis and clinical application.

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1）Department of Pediatrics, The Toyokawa City Hospital
2）Department of Pediatrics, Fujita University School of Medicine
3）Department of Pediatrics, Fujita Health University Okazaki Medical Center

Key words	Kawasaki disease, arthritis, cytokines, steroid, juvenile idiopathic arthritis
Received	May 24, 2023
Accepted	October 25, 2023

35 (4)：363─372,2023