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Serum free carnitine levels in children with Kawasaki disease
Taichiro Muto1, Nami Nakamura1, Yu Masuda1
1Department of Pediatrics, Aichi Medical University, Aichi, Japan.
Insights
Serum free carnitine (FC) levels were higher in children with Kawasaki disease (KD) who did not respond to treatment. These FC levels also correlated with liver enzymes, suggesting a link between carnitine metabolism and KD severity.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Metabolic Disorders
Background:
- Carnitine is crucial for fatty acid transport into mitochondria for energy production.
- Kawasaki disease (KD) is an acute febrile illness affecting children, with unknown precise etiology.
- No prior studies have investigated carnitine levels in pediatric patients diagnosed with KD.
Purpose of the Study:
- To characterize serum free carnitine (FC) levels in hospitalized children diagnosed with Kawasaki disease.
- To explore the relationship between FC levels and treatment response to intravenous immunoglobulin (IVIG).
Main Methods:
- Retrospective analysis of 45 pediatric patients with KD.
- Measurement of serum FC levels prior to IVIG administration.
- Correlation analysis of FC levels with clinical and laboratory parameters, including liver enzymes (AST, ALT) and treatment response.
Main Results:
- Serum FC levels were significantly higher in non-responders (35.3 μmol/L) compared to responders (31.4 μmol/L) to IVIG.
- 80% of responders had pre-treatment FC levels below the normal range.
- Elevated FC levels correlated with higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in non-responders.
Conclusions:
- Elevated serum free carnitine is observed in some children with KD, particularly those refractory to IVIG treatment.
- FC levels in KD patients show a correlation with AST and ALT levels, indicating a potential link to liver function and disease severity.
Background:
Carnitine plays an essential role in the transfer of long-chain fatty acids to the mitochondria for β-oxidation. No study has characterized carnitine in children with Kawasaki disease (KD). The objective of this study was to elucidate the characteristics of serum free carnitine (FC) in hospitalized pediatric patients with KD.
Methods:
We retrospectively analyzed 45 patients with KD in whom serum FC levels were measured. We investigated the clinical and laboratory parameters before intravenous immunoglobulin was administered, including serum FC levels, according to the response to intravenous immunoglobulin (IVIG). We also analyzed the relationship among serum FC, laboratory data, and clinical variables.
Results:
IVIG was effective in 33 children (responders) and was ineffective in 12 children (non-responders). Serum FC levels were higher in non-responders than in responders: 35.3 μmol/L (range, 26.8-118.4 μmol/L) vs 31.4 μmol/L (range, 20.9-81.2 μmol/L), P <0.05. FC levels before IVIG in 80% of responders were below the normal range. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and FC were higher in non-responders than in responders. FC levels were correlated with AST (R2 = 0.364, P = 0.0015) and ALT (R2 = 0.423, P < 0.001) levels.
Conclusions:
Free carnitine levels were elevated in some patients with KD, especially in those who were refractory to IVIG. Additionally, FC levels in children with KD correlated with ASL and ALT levels.
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