Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

Huang, Hsin-Ping; Lai, Yi-Chun; Tsai, I-Jung; Chen, Shih‐Yu; Cheng, Chi-Hui; Tsau, Yong-Kwei

doi:10.1203/pdr.0b013e31815ef737

Cited by 11 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Plasma levels of TGF-β2 in our KD subjects were low in the acute compared to the convalescent phase. Similar findings have been reported for TGF-β1 plasma levels and transcript abundance in acute KD but were not measured in this study 33-35…”

Section: Discussionsupporting

confidence: 90%

Transforming Growth Factor-β Signaling Pathway in Patients With Kawasaki Disease

Shimizu

Jain

Hibberd

et al. 2011

Circ Cardiovasc Genet

133

106

View full text Add to dashboard Cite

Background— Transforming growth factor (TGF)-β is a multifunctional peptide that is important in T-cell activation and cardiovascular remodeling, both of which are important features of Kawasaki disease (KD). We postulated that variation in TGF-β signaling might be important in KD susceptibility and disease outcome. Methods and Results— We investigated genetic variation in 15 genes belonging to the TGF-β pathway in a total of 771 KD subjects of mainly European descent from the United States, the United Kingdom, Australia, and the Netherlands. We analyzed transcript abundance patterns using microarray and reverse transcriptase–polymerase chain reaction for these same genes, and measured TGF-β2 protein levels in plasma. Genetic variants in TGFB2 , TGFBR2 , and SMAD3 and their haplotypes were consistently and reproducibly associated with KD susceptibility, coronary artery aneurysm formation, aortic root dilatation, and intravenous immunoglobulin treatment response in different cohorts. A SMAD3 haplotype associated with KD susceptibility replicated in 2 independent cohorts and an intronic single nucleotide polymorphism in a separate haplotype block was also strongly associated (A/G, rs4776338) ( P =0.000022; odds ratio, 1.50; 95% confidence interval, 1.25 to 1.81). Pathway analysis using all 15 genes further confirmed the importance of the TGF-β pathway in KD pathogenesis. Whole-blood transcript abundance for these genes and TGF-β2 plasma protein levels changed dynamically over the course of the illness. Conclusions— These studies suggest that genetic variation in the TGF-β pathway influences KD susceptibility, disease outcome, and response to therapy, and that aortic root and coronary artery Z scores can be used for phenotype/genotype analyses. Analysis of transcript abundance and protein levels further support the importance of this pathway in KD pathogenesis.

show abstract

Section: Discussionsupporting

confidence: 90%

Transforming Growth Factor-β Signaling Pathway in Patients With Kawasaki Disease

Shimizu

Jain

Hibberd

et al. 2011

Circ Cardiovasc Genet

133

106

View full text Add to dashboard Cite

show abstract

“…Huang et al (12) reported a high incidence (70% of 20 cases) of nephromegaly in patients with KD who had ever received renal ultrasound exam. A higher plasma hepatocyte growth factor (HGF) to transforming growth factor β1 (TGF-β1) ratio (HGF/TGF-β1) was noted in patients with KD.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in patients with Kawasaki disease

et al. 2016

Self Cite

View full text Add to dashboard Cite

“…Huang et al [ 79 ] measured the kidney lengths of 20 patients with KD and with normal renal function, 20 healthy children, and 15 febrile children using renal US. They also measured the levels of plasma hepatocyte growth factor (HGF) and transforming growth factor- β 1 (TGF- β 1) in all the children.…”

Section: Renal Abnormalities In Imaging Studiesmentioning

confidence: 99%

Kidney and Urinary Tract Involvement in Kawasaki Disease

Watanabe

2013

International Journal of Pediatrics

View full text Add to dashboard Cite

Kawasaki disease (KD) is a systemic vasculitis and can develop multiple organ injuries including kidney and urinary tract involvement. These disorders include pyuria, prerenal acute kidney injury (AKI), renal AKI caused by tubulointerstitial nephritis (TIN), hemolytic uremic syndrome (HUS), and immune-complex mediated nephropathy, renal AKI associated with either Kawasaki disease shock syndrome or unknown causes, acute nephritic syndrome (ANS), nephrotic syndrome (NS), renal tubular abnormalities, renal abnormalities in imaging studies, and renal artery lesions (aneurysms and stenosis). Pyuria is common in KD and originates from the urethra and/or the kidney. TIN with AKI and renal tubular abnormalities probably result from renal parenchymal inflammation caused by T-cell activation. HUS and renal artery lesions are caused by vascular endothelial injuries resulting from vasculitis. Some patients with ANS have immunological abnormalities associated with immune-complex formation. Nephromegaly and renal parenchymal inflammatory foci are detected frequently in patients with KD by renal ultrasonography and renal scintigraphy, respectively. Although the precise pathogenesis of KD is not completely understood, renal vasculitis, immune-complex mediated kidney injuries, or T-cell immune-regulatory abnormalities have been proposed as possible mechanisms for the development of kidney and urinary tract injuries.

show abstract

Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

Cited by 11 publications

References 23 publications

Transforming Growth Factor-β Signaling Pathway in Patients With Kawasaki Disease

Transforming Growth Factor-β Signaling Pathway in Patients With Kawasaki Disease

Acute kidney injury in patients with Kawasaki disease

Kidney and Urinary Tract Involvement in Kawasaki Disease

Contact Info

Product

Resources

About