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Platelet tocopherol levels in mucocutaneous lymph node syndrome (MCLS: Kawasaki disease)
Insights
Platelet tocopherol levels in children with mucocutaneous lymph node syndrome (MCLS) are generally higher and correlate with plasma lipids, not disease severity. These findings offer insights into vitamin E status during MCLS.
Area of Science:
- Biochemistry
- Pediatrics
- Immunology
Background:
- Mucocutaneous lymph node syndrome (MCLS) is an acute febrile illness affecting young children.
- Vitamin E (tocopherol) plays a crucial role in antioxidant defense, but its status in MCLS is not well understood.
Purpose of the Study:
- To investigate changes in plasma and platelet tocopherol levels during the course of MCLS.
- To examine the correlation between tocopherol levels and disease progression or risk stratification in MCLS patients.
Main Methods:
- Longitudinal study of plasma and platelet tocopherol levels in 16 children with MCLS.
- Comparison of tocopherol levels with 24 healthy children.
- Assay of plasma tocopherol/total lipid ratio and correlation analysis with platelet tocopherol.
Main Results:
- Plasma tocopherol was lowest in the first 1-2 weeks of MCLS, increasing with symptom improvement.
- Platelet tocopherol was lowest in the first 2-3 weeks, rising later and generally higher than in healthy controls.
- A significant correlation was found between platelet tocopherol and plasma tocopherol/total lipid ratio (r=0.55, p<0.001).
Conclusions:
- Platelet tocopherol levels may be elevated in children with MCLS.
- The plasma tocopherol/total lipid ratio is a better indicator of platelet tocopherol status than plasma tocopherol alone in MCLS.
- No correlation was observed between tocopherol levels and MCLS risk stratification.
Abstract:
Studies of changes in platelet tocopherol in 16 children with mucocutaneous lymph node syndrome (MCLS) were undertaken during the disease course. Plasma tocopherol was lowest at the beginning of the disease (during the first 1 to 2 weeks), while it increased with improvement in symptoms at 4 to 5 weeks. Platelet tocopherol however was lowest in the first 2 to 3 weeks, and at about the 4th week or later increased. When compared with normal levels, determined in 24 children without MCLS (5 to 14 years old), the lowest level seen throughout the disease course coincided with it. Thus, platelet tocopherol may be generally higher in MCLS. There was little correlation between plasma and platelet tocopherol levels which were simultaneously assayed, (r = 0.26, p less than 0.1, n = 44), while, the correlation between platelet tocopherol and plasma tocopherol/total lipid ratio was increased significantly to 0.55 (p less than 0.001, n = 38). Individual patients in whom platelet tocopherol and plasma tocopherol/total lipid ratios were repeatedly assayed, were divided into two groups based on the Asai scoring, as a high risk group and a low risk group. No correlation was observed between the risk grades and either platelet tocopherol or tocopherol/total lipid ratios in plasma.