Korean Circ J.  2021 Mar;51(3):267-278. 10.4070/kcj.2020.0345.

IgA Levels Are Associated with Coronary Artery Lesions in Kawasaki Disease

  • 1Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
  • 2Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • 3Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
  • 4Department of Pediatrics, The Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Korea
  • 5Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
  • 6Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
  • 7Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
  • 8Department of Pediatrics, University of Ulsan, Gangneung Asan Hospital, Gangneung, Korea
  • 9Department of Pediatrics, Inje University Paik Hospital, Busan, Korea
  • 10Department of Pediatrics, Pusan National University Hospital, Busan, Korea
  • 11Department of Pediatrics and Adolescent Medicine, Myongji Hospital, Goyang, Korea
  • 12Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
  • 13Department of Pediatrics, Ewha Womans University Hospital, Seoul, Korea
  • 14Department of Pediatrics, Korea University Ansan Hospital, Ansan, Korea


Background and Objectives
Kawasaki disease (KD) is an acute systemic vasculitis that affects the coronary arteries. Abnormal immune reactions are thought to contribute to disease pathogenesis. The effect of immunoglobulin (Ig) isotype (IgG, IgA, IgM, and IgE) on inflammatory data and clinical outcomes of patients with KD was examined.
Ig levels in 241 patients with KD were measured during the acute, subacute, convalescent, and normal phases of the disease.
Compared with reference Ig values, IgG, IgA, and IgM levels were significantly higher in the subacute phase, while IgE levels were elevated in 73.9% (178/241) of patients with KD in all clinical phases. However, high IgE levels were not associated with clinical outcomes, including intravenous immunoglobulin unresponsiveness and coronary artery lesions (CALs). Significantly more CALs were observed in the high IgA group than in the normal IgA group (44.7% vs. 20.8%, respectively; p<0.01). In addition, IgA levels in the acute phase (p=0.038) were 2.2-fold higher, and those in the subacute phase were 1.7-fold higher (p <0.001), in the CAL group than in the non-CAL group. IgA concentrations increased along with the size of the coronary artery aneurysm (p <0.001). Furthermore, there was a strong correlation between IgA levels and CAL size (r=0.435, p<0.001), with a high odds ratio of 2.58 (p=0.022).
High IgA levels in patients with KD are prognostic for the risk of CALs.


Mucocutaneous lymph node syndrome; IgA; Coronary aneurysms
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