title: Prediction of intravenous immunoglobulin resistance in Kawasaki disease in an East China population.
abstract: The objectives of the study were to find the risk factors associated with intravenous immunoglobulin (IVIG) resistance and generate a prediction scoring system of IVIG resistance in patients with Kawasaki disease (KD). We retrospectively reviewed the clinical records of KD patients between January 2006 and December 2014. Multivariate logistic regression was performed to identify the risk factors of IVIG non-responders. The independent risk factors were used to construct a new scoring system and compared with Kobayashi and Egami scoring systems. Multivariate logistic regression analysis identified age <6 months, rash, edema of extremities, % neutrophils, and serum albumin as independent risk factors for IVIG non-responders. We assigned one point for rash, edema of extremities, and % neutrophils ≥80 %. Two points were assigned for age <6 months and serum albumin <35 g/L. Using a cutoff point of three or more, we identified the IVIG non-responders with 71.4 % sensitivity and 76.0 % specificity. The new scoring system had a relatively better performance than Kobayashi and Egami scoring systems in the KD patients in East China. Clinical pediatricians must pay more attention to these high-risk patients, and use of additional therapies early in the course of their illness is necessary.
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Yunjia
authors: Y
authors: Tang
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Wenhua
authors: W
authors: Yan
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Ling
authors: L
authors: Sun
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Jie
authors: J
authors: Huang
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Weiguo
authors: W
authors: Qian
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China.
authors: Yueyue
authors: Y
authors: Ding
authors: The Department of Cardiology, Children's Hospital of Soochow University, Suzhou, 215003, China. haitaosz@163.com.
authors: Haitao
authors: H
authors: Lv
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002681:China; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D017211:Treatment Failure
chemical_list: D016756:Immunoglobulins, Intravenous; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: Children; Intravenous immunoglobulin; Kawasaki disease; Resistance