Assessment of intravenous immunoglobulin non-responders in Kawasaki disease.
The authors compared pre-treatment and post-treatment characteristics of 206 prospectively enrolled patients with Kawasaki disease (KD) responsive to intravenous immunoglobulin (IVIG) with those of 23 (10% of total) IVIG non-responders. Demographic characteristics were similar in both groups. Compared to IVIG responders, non-responders had a longer total duration of fever and a higher incidence of coronary artery lesions. Prior to IVIG, non-responders had higher neutrophil differential and C-reactive protein, and lower cholesterol. 24 hours after the IVIG infusion, a total leucocyte count >13.1×10(9)/l, neutrophil differential >51% and total protein <72 g/l showed reasonable sensitivity (91%, 91% and 64%, respectively) and specificity (89%, 76% and 78%, respectively) as independent characteristics of non-response to IVIG. Laboratory parameters before and shortly after IVIG may reflect the severity of inflammation in KD patients and assist in informing further management.
Hwang
Ja-Young
JY
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lee
Kyung-Yil
KY
Rhim
Jung-Woo
JW
Youn
You-Sook
YS
Oh
Jin-Hee
JH
Han
Ji-Whan
JW
Lee
Joon-Sung
JS
Burgner
David
D
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy*; D009504:Neutrophils / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D017211:Treatment Failure
D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D002097:C-Reactive Protein; D002784:Cholesterol