Sonographic gallbladder abnormality is associated with intravenous immunoglobulin resistance in Kawasaki disease.
OBJECTIVE
Kawasaki disease (KD) is an acute systematic vasculitis in children which causes coronary arterial lesions and hydrops of gallbladder. Our objective is to correlate the clinical significance and influence on disease outcome of patients with gallbladder abnormalities in Kawasaki dissease.


METHODS
Children who met KD diagnosis criteria and were admitted for IVIG treatment were retrospectively enrolled for analysis. Patients with abdominal sonography were divided into 2 groups based on the absence (Group A, N = 61) or presence (Group B, N = 16) of gallbladder abnormalities (GBA), defined as hydrops or acalculous cholecystitis. Between the two groups, clinical features, demographic data (including admission days, coronary artery lesions, IVIG resistance), and laboratory data before/after IVIG treatment were collected for analysis.


RESULTS
The presence of sonographic gallbladder abnormalities is correlated with higher levels of serum CRP, GPT, and neutrophils. It also points to an increased number of IVIG resistance rates in group B. There was no significant statistical difference among clinical features, age, gender, admission days, or coronary artery lesions between the two groups.


CONCLUSIONS
Sonographic gallbladder abnormalities are associated with higher CRP, GPT, neutrophil and IVIG resistance in KD. It can be used as a predictor of IVIG resistance in patients with KD.
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chih-Jen
CJ
Chen
Fu-Chen
FC
Huang
Mao-Meng
MM
Tiao
Ying-Hsien
YH
Huang
Li-Yan
LY
Lin
Hong-Ren
HR
Yu
Kuender D
KD
Yang
Yi-Chuan
YC
Huang
Chih-Cheng
CC
Chen
Wei-Chiao
WC
Chang
Ho-Chang
HC
Kuo
D042101:Acalculous Cholecystitis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D002097:C-Reactive Protein / Q000032:analysis; D002675:Child, Preschool; D004351:Drug Resistance; D004487:Edema / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005704:Gallbladder / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D005705:Gallbladder Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D009504:Neutrophils / Q000166:cytology; D012189:Retrospective Studies; D017211:Treatment Failure; D014463:Ultrasonography
D016756:Immunoglobulins, Intravenous; D002097:C-Reactive Protein