RESUMO
PURPOSE: It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. METHODS: We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. RESULTS: Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. CONCLUSION: Two independent predictors (ALT> or =84 IU/L, total bilirubin> or =0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.
Assuntos
Criança , Humanos , Alanina Transaminase , Aspartato Aminotransferases , Bilirrubina , Vasos Coronários , Febre , Hospitalização , Imunização Passiva , Imunoglobulinas , Imunoglobulinas Intravenosas , Modelos Logísticos , Prontuários Médicos , Síndrome de Linfonodos Mucocutâneos , Peptídeo Natriurético Encefálico , Neutrófilos , Piúria , Estudos RetrospectivosRESUMO
Since urachal abnormalities are uncommon and have various clinical manifestations such as umbilical discharge, periumbilical pain, recurrent urinary tract infection and abdominal mass according to its structure, it is not easy to diagnose. We report our experience of a patient with urachal remnant abscess who presented with gross hematuria initially, and improved after the management with intravenous antibiotics and percutaneous drainage of abscess.
Assuntos
Criança , Humanos , Abscesso , Antibacterianos , Drenagem , Hematúria , Infecções UrináriasRESUMO
We report on two children with a high risk of recurrent focal segmental glomerulosclerosis (FSGS) after renal transplantation that could be effectively prevented by prophylactic administration of cyclosporine combined with preemptive plasmapheresis prior to renal transplantation.