Plasma clusterin concentrations may predict resistance to intravenous immunoglobulin in patients with Kawasaki

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Mei-Chen Ou-Yang1, Ho-Chang Kuo, I-Chun Lin

  • 1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Niao-Sung, Kaohsiung 833, Taiwan.

Thescientificworldjournal
|August 20, 2013
PubMed

Insights

Plasma clusterin levels before and after treatment can predict if children with Kawasaki disease (KD) will resist intravenous immunoglobulin (IVIG). This finding aids in early identification of non-responders for better Kawasaki disease management.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Vascular Biology

Background:

  • Kawasaki disease (KD) is a critical childhood illness causing febrile vasculitis and potential coronary artery damage.
  • Intravenous immunoglobulin (IVIG) is a primary treatment, but some patients exhibit resistance, necessitating alternative strategies.
  • Identifying predictive markers for IVIG resistance is crucial for optimizing KD patient care and preventing long-term complications.

Purpose of the Study:

  • To determine if plasma clusterin concentration can serve as a reliable biomarker for predicting IVIG resistance in pediatric KD patients.
  • To evaluate the difference in plasma clusterin levels before and after IVIG infusion (CLUSTER 12) as a predictor of treatment non-responsiveness.

Main Methods:

  • Sixty-three KD patients were studied, with plasma samples collected pre- and post-IVIG treatment.
  • Plasma clusterin concentrations were measured, and clinical/laboratory data were analyzed.
  • Receiver operating characteristic (ROC) curve analysis was employed to establish a predictive cut-off value for IVIG resistance.

Main Results:

  • A significant association was found between the change in plasma clusterin concentration (CLUSTER 12) and IVIG resistance (P = 0.040).
  • A CLUSTER 12 cut-off value of <8.52 mg/L indicated a significantly higher risk of IVIG resistance (Odds Ratio: 11.467).
  • Patients with CLUSTER 12 concentrations >8.52 mg/L demonstrated a substantially increased likelihood of IVIG resistance.

Conclusions:

  • Plasma clusterin concentration, specifically the change before and after IVIG (CLUSTER 12), shows significant promise as a predictive biomarker for IVIG resistance in Kawasaki disease.
  • This biomarker may facilitate early identification of non-responsive patients, allowing for timely therapeutic adjustments and improved outcomes in Kawasaki disease management.

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