Elevation of Serum Thrombopoietin Precedes Thrombocytosis in Kawasaki Disease

Akira Ishiguro; Takashi Ishikita; Toshikazu Shimbo; Kousaku Matsubara; Kunizou Baba; Yasuhide Hayashi; Shin-ichi Naritaka; Tatsutoshi Nakahata

doi:10.1055/s-0037-1615022

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 79(06): 1096-1100
DOI: 10.1055/s-0037-1615022

Rapid Communication

Schattauer GmbH

Elevation of Serum Thrombopoietin Precedes Thrombocytosis in Kawasaki Disease

Akira Ishiguro

¹From the Department of Pediatrics, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki

,

Takashi Ishikita

¹From the Department of Pediatrics, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki

,

Toshikazu Shimbo

¹From the Department of Pediatrics, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki

,

Kousaku Matsubara

²Department of Pediatrics, Nishi-Kobe Medical Center, Kobe

,

Kunizou Baba

²Department of Pediatrics, Nishi-Kobe Medical Center, Kobe

,

Yasuhide Hayashi

³Department of Pediatrics, Faculty of Medicine, The University of Tokyo, Tokyo

,

Shin-ichi Naritaka

³Department of Pediatrics, Faculty of Medicine, The University of Tokyo, Tokyo

,

Tatsutoshi Nakahata

⁴Department of Clinical Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

› Author Affiliations

Abstract

Summary

Kawasaki disease (KD) is an acute systemic vasculitis causing coronary arterial aneurysms and myocardial infarction in young children. Prominent thrombocytosis with increased megakaryocytes develops during the convalescent period. To clarify the mechanisms of thrombocytosis, we studied serum levels of thrombopoietin (TPO) and other thrombopoietic cytokines in 40 patients with KD (149 samples) and 106 age-matched controls using ELISA. TPO values in the controls were 1.94 ± 0.69 fmol/ml (mean ± SD) with a 95% reference interval of 0.85 to 3.27 fmol/ml. In the first week of KD, platelet counts were normal but TPO values increased (~ 15.5 fmol/ml). TPO levels peaked on day 6 ± 2 at 5.94 ± 2.64 fmol/ml and then fell gradually. When platelet counts peaked in the second to third weeks, TPO levels were still high or comparable with the controls. TPO levels in KD patients with normal platelet counts were significantly higher than control levels. Interleukin (IL)-6 levels in the first week rose, but neither IL-11 nor leukemia inhibitory factor was detectable. These results suggest that TPO contributes to thrombocytosis in KD in conjunction with IL-6 and TPO production may be enhanced during the acute phase.

Full Text

References

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