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Prediction of Resistance to Standard Intravenous Immunoglobulin Therapy in Kawasaki Disease
Korean Circulation Journal ; : 415-422, 2014.
Artículo en Inglés | WPRIM | ID: wpr-149410
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Ten to twenty percent of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) treatment. If untreated, approximately 15% to 25% of KD patients have complications. The aim of this study was to find useful predictors of responsiveness to initial IVIG treatment in KD. SUBJECTS AND

METHODS:

We retrospectively reviewed medical records of 91 children diagnosed with KD at Myong Ji Hospital from March 2012 to April 2014. Before and after (24 hours to 36 hours) IVIG treatment, the following laboratory data were obtained hemoglobin (Hb) level, white blood cell count, proportion of neutrophil, lymphocyte and eosinophil, platelet count, erythrocyte sedimentation rate (ERS), C-reactive protein (CRP), creatine kinase (CK), creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP). Subjects were then divided into two groups IVIG-responsive or IVIG-resistant.

RESULTS:

Of 91 patients, 11 (12%) required retreatment. By univariate analysis, before-IVIG laboratory parameters of white blood cell count, % neutrophil, ERS, CRP, sodium, CK, CK-MB, and NT-proBNP were significantly different between IVIG-responsive and IVIG-resistant patient groups. In the after-IVIG laboratory parameters, Hb level, white blood cell count, % neutrophil, % lymphocyte, CRP, CK, CK-MB, and NT-pro-BNP were significantly different between the two groups. While the mean-differences were not statistically significant, fractional change (FC)-CRP and FC-% neutrophil showed significant difference. By multivariate analysis, FC-CRP was confirmed to be an independent predictor for initial IVIG resistance.

CONCLUSION:

Fractional change-C-reactive protein might be a useful and important value for predicting initial IVIG resistance in KD patients.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Recuento de Plaquetas / Sodio / Sedimentación Sanguínea / Proteína C-Reactiva / Inmunoglobulinas / Linfocitos / Registros Médicos / Análisis Multivariante / Estudios Retrospectivos / Factores de Riesgo Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Niño / Humanos Idioma: Inglés Revista: Korean Circulation Journal Año: 2014 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Recuento de Plaquetas / Sodio / Sedimentación Sanguínea / Proteína C-Reactiva / Inmunoglobulinas / Linfocitos / Registros Médicos / Análisis Multivariante / Estudios Retrospectivos / Factores de Riesgo Tipo de estudio: Estudio de etiología / Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Niño / Humanos Idioma: Inglés Revista: Korean Circulation Journal Año: 2014 Tipo del documento: Artículo