Limited Clinical Associations of Age-Adjusted Serum Thymus and Activation-Regulated Chemokine in Kawasaki Disease.

backgroundKawasaki disease is an acute systemic vasculitis, and the clinical significance of serum thymus and activation-regulated chemokine (TARC) remains incompletely understood. We examined whether pre-treatment age-adjusted serum TARC was associated with inflammation-based intravenous immunoglobulin (IVIG) resistance risk stratification.

methodsWe retrospectively studied 109 children with Kawasaki disease after excluding documented allergic comorbidities and age younger than 6 months. All included patients had serum TARC measured before initial treatment, and 18 of them also had paired post-treatment measurements. Serum values were expressed as the percentage of the age-specific upper limit of normal. The primary analysis compared pre-treatment values between high- and low-risk groups according to the Kobayashi score. Paired pre- and post-treatment changes and exploratory analyses of other IVIG resistance risk scores and treatment non-response were also assessed.

resultsTwenty children were classified as high risk by the Kobayashi score. Pre-treatment age-adjusted values were lower in the high-risk group than in the low-risk group, but logistic regression analysis did not support a statistically robust association. In 18 children with paired samples, values decreased significantly after treatment. Exploratory analyses showed no significant associations with other IVIG resistance risk scores, whereas analyses of treatment non-response and coronary artery lesions were limited by the small number of events.

conclusionsAge-adjusted serum TARC showed limited clinical associations during the acute phase of Kawasaki disease and was not robustly associated with inflammation-based high-risk classification. Its role in treatment response and coronary artery outcomes remains to be clarified.