title: Plasma clusterin concentrations may predict resistance to intravenous immunoglobulin in patients with Kawasaki disease.
abstract: Kawasaki disease (KD) is an acute febrile vasculitic syndrome of early childhood often complicated by coronary artery lesion that drastically reduces the quality of life. The study aimed to identify a reliable marker for predicting nonresponsiveness to the first course of intravenous immunoglobulin (IVIG) in KD patients. A total of 63 patients with KD were enrolled in the study (IVIG response, 58; IVIG resistance, 5). Plasma samples were collected before and after IVIG infusion for measurement of biomarkers. Patients' clinical characteristics and laboratory data were also analyzed. A receiver operating characteristic curve was generated to identify a cut-off value for predicting IVIG resistance. Among the biomarkers, the difference in plasma clusterin concentrations before and after IVIG infusion (CLUSTER 12) was significantly related to IVIG resistance (P = 0.040; 95% confidence interval (CI): -25.8% to -6.0%). Using a CLUSTER 12 cut-off value of <8.52 mg/L, the odds ratio for IVIG resistance was 11.467 (95% CI: 1.186 to 110.853). Patients with plasma CLUSTER 12 concentrations >8.52 mg/L had a much higher risk of IVIG resistance than those with CLUSTER 12 concentrations <8.52 mg/L. Plasma clusterin concentration shows promise as a candidate biomarker for predicting IVIG resistance in patients with KD.
authors: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Niao-Sung, Kaohsiung 833, Taiwan.
authors: Mei-Chen
authors: MC
authors: Ou-Yang
authors: Ho-Chang
authors: HC
authors: Kuo
authors: I-Chun
authors: IC
authors: Lin
authors: Jiunn-Ming
authors: JM
authors: Sheen
authors: Fu-Chen
authors: FC
authors: Huang
authors: Chih-Cheng
authors: CC
authors: Chen
authors: Ying-Hsien
authors: YH
authors: Huang
authors: Ying-Jui
authors: YJ
authors: Lin
authors: Hong-Ren
authors: HR
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D051152:Clusterin / Q000097:blood*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C495242:CLU protein, human; D051152:Clusterin; D016756:Immunoglobulins, Intravenous
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