Objective: To assess the diagnostic potential of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-endothelial cell antibodies (AECA) to distinguish early Kawasaki disease (KD) from febrile diseases resembling KD.
Design: Case-control study.
Setting: Tertiary care facility.
Patients: Eighteen patients with KD tested within 2 weeks of disease onset and before immune globulin therapy; 20 control children with fever and at least one other KD criterion; 21 children with noninflammatory disorders (patients scheduled for elective surgery, or after trauma).
Methods: We detected ANCA by immunofluorescence and enzyme-linked immunosorbent assay (ELISA), and AECA by a cell-ELISA with fixed human umbilical vein endothelial cells.
Results: We found that 7 of 18 patients with KD and 6 of 20 febrile control patients had ANCA (by immunofluorescence or ELISA, p value not significant); 3 of 18 patients with KD and 8 of 20 febrile control patients had AECA (p value not significant). One of three patients with KD who had aneurysms had ANCA; none had AECA.
Conclusions: The ANCA and AECA tests used in this study did not differentiate early KD from other childhood diseases with which it may be confused.