Prediction of repeated intravenous immunoglobulin resistance in children with Kawasaki disease

Yaheng Lu; Tingting Chen; Yizhou Wen; Feifei Si; Xindan Wu; Yanfeng Yang

doi:10.1186/s12887-021-02876-w

BMC Pediatrics (Sep 2021)

Prediction of repeated intravenous immunoglobulin resistance in children with Kawasaki disease

Yaheng Lu,
Tingting Chen,
Yizhou Wen,
Feifei Si,
Xindan Wu,
Yanfeng Yang

Affiliations

Yaheng Lu: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Tingting Chen: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yizhou Wen: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Feifei Si: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Xindan Wu: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China
Yanfeng Yang: Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China

DOI: https://doi.org/10.1186/s12887-021-02876-w
Journal volume & issue: Vol. 21, no. 1
pp. 1 – 9

Abstract

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Abstract Background Repeated intravenous immunoglobulin (IVIG) resistance prediction is one of the pivotal topics in Kawasaki disease (KD). Those non-responders of repeated IVIG treatment might be improved by an early-intensified therapy to reduce coronary artery lesion and medical costs. This study investigated predictors of resistance to repeated IVIG treatment in KD. Methods A total of 94 children with IVIG-resistant KD treated at our hospital between January 2016 and August 2020 were retrospectively analyzed. According to the therapeutic effect of a second dose IVIG treatment, the children were divided into repeated IVIG-responsive group and repeated IVIG-resistant group, and the clinical and laboratory data were compared. Predictors of repeated IVIG resistance and the optimal cut-off value were determined by multiple logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results The Pre-IVIG laboratory data showed the percentage of neutrophils (N%) and levels of serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP) were significantly higher in repeated IVIG-resistant group compared with repeated IVIG-responsive group, while levels of serum sodium and albumin (ALB) were significantly lower (P 1.81ng/ml (OR 4.1, 95 % CI 1.4 ~ 12.0, P 45 mg/L (OR 4.6, 95 % CI 1.3 ~ 16.2, P < 0.05) were independent predictors of repeated IVIG resistance in KD. Conclusions Our study illustrates the serum PCT level before initial IVIG treatment and CRP after initial IVIG could be used to predict repeated IVIG resistance in KD.

Published in BMC Pediatrics

ISSN: 1471-2431 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Pediatrics
Website: https://bmcpediatr.biomedcentral.com

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