Table: Details of patients with KD T helper 17 (Th17) and T regulatory (Treg) cells in children with Kawasaki disease – experience from a tertiary care centre in North India Sagar Bhattad1, Amit Rawat1, Biman Saikia2, Ranjana W.Minz2, Jitendra Shandilya1, Surjit Singh2 1Pediatric Allergy and Immunology Unit, Dept of Pediatrics, 2 Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India Male: female ratio amongst cases - 4:1 Mean age at onset of KD - 4.45 years Youngest child - 6 months old Mean duration of fever at presentation - 10.7 days 60% of children presented beyond 10 days of onset of fever Introduction Results Table: Details of patients with KD Total patients 10 Age (Mean) 4.45 years (6 months – 9 years) Sex (M:F) 8:2 Duration of fever (Mean/S.D) 10.7 (4.9) days Conjunctival injection 5 (50%) Oral mucosal changes 7 (70%) Cervical lymphadenopathy 6 (60%) Rash Extremity edema Peeling of skin 10 (100%) Irritability Arthritis/arthralgia 2 (20%) Coronary artery dilatation 3 (30%) Coronary aneurym Myocarditis 1 (10%) Jaundice Acute kidney injury Sterile pyuria Recurrent KD Incomplete KD 4 (40%) IVIg resistant KD Severe KD warranting additional therapy (infliximab) Family history of KD Kawasaki disease (KD) is an acute necrotizing vasculitis with predilection for coronary arteries Acute KD has been associated with abnormalities in T-helper 17 (Th17)/ T-regulatory (Treg) cells and a high Th17/low Treg profile predict poor outcome in acute KD Objectives To estimate Th17 and Treg cells in children with acute KD   Cases (Pre- IVIg) Cases (Post-IVIg) Febrile controls Controls Th17 cells 2.58 % 1.88% 1.57 % 2 % Treg cells 0.99 % 2.64% 1.96 % 2.37 % Methods Study setting: Pediatric Allergy Immunology Unit, Advanced Pediatrics Centre, PGIMER, Chandigarh Study duration: Jan – Dec 2015 Study population: 10 children with acute KD Controls: 17 healthy controls and 9 febrile controls (not suffering from KD) Th17 and Treg cells were estimated at admission (pre-IVIg) and at 4-8 weeks of follow-up in cases. Samples for febrile controls were drawn only at the first instance. Estimation of Th17 and Treg cells was carried out by flow cytometry using the Th17/Treg phenotyping kit that contains PerCP-Cy5.5 labeled anti-CD4, Phycoerythrin (PE) labeled anti-IL-17 and AlexaFluor labeled anti-FoxP3 antibody Parameter Mean (S.D) Hemoglobin 96 g/L (15) Leukocyte counts 17.79 x 109/L (9.37 x 109) Platelet counts 652 x 109/L (273 x 109) ESR 57 mm/1st hr (23) CRP 62 mg/L (89) Serum Sodium 136.5 meq/L (4.1) Albumin 3.2 g/dl (0.74) AST 32.8 (7.1) ALT 29 (7.6) Representative density plot to show gating of cells and determination of Th17 and Tregs by flow cytometric analysis in a child with KD Comparision of Th17 and Treg proportions at admission (pre-IVIG) in cases with and without CAA Pre-IVIg KD-CAA+ KD-CAA‑ P-value Th17 2.61 % 2.56 % 0.732 Treg 1.17 % 0.67 % 0.569 Conclusions Comparision of Th17 and Treg proportions at admission (post-IVIG) in cases with and without CAA Th17 cells were elevated and Tregs were reduced during acute KD as compared to febrile and healthy controls; the difference, however, was not statistically significant Larger studies that evaluate Th17 and Tregs in KD are needed to confirm the differences of statistical significance Post-IVIg KD-CAA+ KD-CAA‑ P-value Th17 1.78 % 1.98 % 0.732 Treg 3.45 % 2.63 % drsagarbhattad@gmail.com