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Predicting factors for refractory kawasaki disease.
Young-Sun Do1, Ki-Won Kim, Jin-Kyong Chun
1Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Korean Circulation Journal
|June 2, 2010
Summary
Predicting factors for refractory Kawasaki disease (KD) were identified. Lower lymphocyte counts and serum albumin/sodium levels, along with higher Kobayashi scores, may indicate resistance to intravenous immunoglobulin (IVIG) therapy.
Area of Science:
- Pediatrics
- Immunology
- Rheumatology
Background:
- Kawasaki disease (KD) affects children, with 10-15% showing resistance to initial intravenous immunoglobulin (IVIG) treatment.
- Identifying predictors of IVIG resistance is crucial for timely management and preventing complications.
Purpose of the Study:
- To investigate predictive factors for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD).
Main Methods:
- Retrospective analysis of 77 typical KD patients' clinical records.
- Comparison of laboratory and demographic parameters between IVIG-responsive and IVIG-resistant groups.
- Inclusion of 13 febrile control patients with urinary tract infections.
Main Results:
- 16.9% of KD patients were IVIG-resistant.
- IVIG-resistant group had longer febrile periods and hospital stays.
- Lower serum albumin and sodium levels, and fewer lymphocytes were observed in the IVIG-resistant group.
- Higher Kobayashi scores differentiated the groups.
- Coronary arterial dilatations (CADs) were more frequent in IVIG-resistant patients (38.5% vs 10.9%).
Conclusions:
- Neutrophil and lymphocyte percentages, alongside known risk factors, can predict IVIG resistance in Kawasaki disease.
- Early identification of refractory KD may guide treatment adjustments and improve outcomes.
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