Metabolomic Profiling for Predicting Coronary Artery Aneurysms and IVIG Resistance in Kawasaki Disease- An Exploratory Study

We investigated the metabolomic profile of Kawasaki disease(KD) and its association with the development of coronary artery aneurysms (CAA) and resistance to intravenous immunoglobulin(IVIG) therapy. Metabolomic profiling was performed on 26 patients with KD. A total of 44 metabolites—including 12 amino acids, L-carnitine, and 31 acylcarnitines—were analyzed using liquid chromatography-tandem mass spectrometry (LC–MS/MS) after IVIG administration. Methylglutarylcarnitine, a medium-chain acylcarnitine, was identified as a differentially expressed metabolite in KD patients with CAA. Additionally, C2, C3, C14, C16, C16OH, C18:2, and C18:2OH were differentially expressed between IVIG-resistant and IVIG-responsive patients. Pathway analysis using the KEGG database revealed that arginine biosynthesis and alanine, aspartate, and glutamate metabolism were among the most affected pathways in KD patients with CAA. This study demonstrated several differentially expressed metabolites in KD patients with CAA and IVIG resistance. These findings provide new insights into the metabolic pathways underlying KD complications.