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The “Intermediate” CD14 + CD16 + monocyte subpopulation plays a role in IVIG responsiveness of children with Kawasaki disease

  • Kim, Yi Seul1, 2
  • Yang, Hyun Jin3
  • Kee, Seung-Jung3, 4
  • Choi, Insu1
  • Ha, Kisoo5
  • Ki, Katrina K6, 7
  • Jeong, In Seok3, 8
  • Cho, Hwa Jin1, 3
  • 1 Chonnam National University Children’s Hospital, 42 Jaebong ro, Gwangju, South Korea , Gwangju (South Korea)
  • 2 Ewha Womans University College of Medicine, Seoul, South Korea , Seoul (South Korea)
  • 3 Chonnam National University Medical School, 42 Jaebong ro, Gwangju, South Korea , Gwangju (South Korea)
  • 4 Chonnam National University Hwasun Hospital, Hwasun, South Korea , Hwasun (South Korea)
  • 5 Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea , Seoul (South Korea)
  • 6 The Prince Charles Hospital, Chermside, Queensland, Australia , Chermside (Australia)
  • 7 The University of Queensland, St. Lucia, Queensland, Australia , St. Lucia (Australia)
  • 8 Chonnam National University Hospital and Medical School, 42 Jaebong ro, Gwangju, South Korea , Gwangju (South Korea)
Published Article
Pediatric Rheumatology
Springer Science and Business Media LLC
Publication Date
May 31, 2021
DOI: 10.1186/s12969-021-00573-7
Springer Nature


BackgroundKawasaki disease (KD) is an acute, self-limited febrile illness of unknown cause. Intravenous immunoglobulin (IVIG)-resistance are related to greater risk for permanent cardiac complications. We aimed to determine the correlation between monocytes and the phenotype of KD in relation to IVIG responsiveness in children.Materials and methods The study cohort included 62 patients who were diagnosed with KD, 20 non febrile healthy controls (NFC), and 15 other febrile controls (OFC). In all enrolled patients, blood was taken at least 4 times and laboratory tests were performed. In addition, subtypes of monocytes were characterized via flow cytometry.ResultsThe numbers of intermediate monocytes were significantly lower in IVIG-resistant group compared to IVIG-responsive group before IVIG infusion (p < 0.0001). After infusion, intermediate monocytes decreased in the responsive group, while a trend of increase was observed in the resistant group. Only intermediate monocytes were significant in logistic regression with adjusted OR of 0.001 and p value of 0.03.ConclusionsCD14 + CD16 + intermediate monocyte may play an important role in IVIG responsiveness among KD children. Low starting levels of intermediate monocytes, followed by a dramatic increase post-IVIG infusion during acute phase of KD are associated with IVIG-resistance. Functional studies on intermediate monocyte may help to reveal the pathophysiology.

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