title: The prognostic role of abnormal liver function in IVIG unresponsiveness in Kawasaki disease: a meta-analysis.
abstract: OBJECTIVE
  We aimed to assess the prognostic role of liver function alteration with intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) by systematically analyzing and summarizing the results from published studies.
  
  
  METHODS
  In this study, we summarized the evidence currently available up to March 31, 2015, and calculated the standard mean difference (SMD) of liver function parameters, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and total bilirubin between IVIG-responsive and IVIG-resistant patients.
  
  
  RESULTS
  We found that the serum levels of these parameters in IVIG-non-responsive patients were significantly higher than that in IVIG-responsive group (total bilirubin: SMD = 0.984, 95%CI 0.712-1.184, p < 0.005; ALT: SMD = 0.555, 95%CI 0.400-0.710, p < 0.005; AST: SMD = 0.602, 95%CI 0.413-0.791, p < 0.005; GGT = 0.551, 95%CI 0.157-0.946, p = 0.006). There was evidence of heterogeneity (I (2) > 50%). The characteristics of patients could be the major sources, as analysis stratified by region significantly removed or reduced the heterogeneity.
  
  
  CONCLUSIONS
  In summary, our meta-analysis suggested that liver abnormality was significantly associated with IVIG unresponsiveness in KD patients. Further study from more clinical investigations is needed to confirm this finding.
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China.
authors.forename: Ruigeng
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China.
authors.forename: Dongming
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China.
authors.forename: Xuelian
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China. dingyanrh@126.com.|Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China. dingyanrh@126.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ding
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D004351:Drug Resistance; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008099:Liver / Q000378:metabolism; D008107:Liver Diseases / Q000097:blood / Q000150:complications*; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D011379:Prognosis; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: Abnormal liver function; Association; Intravenous immunoglobulin unresponsiveness; Meta-analysis