Assessment of intravenous immunoglobulin non-responders in Kawasaki disease.
نویسندگان
چکیده
The authors compared pre-treatment and post-treatment characteristics of 206 prospectively enrolled patients with Kawasaki disease (KD) responsive to intravenous immunoglobulin (IVIG) with those of 23 (10% of total) IVIG non-responders. Demographic characteristics were similar in both groups. Compared to IVIG responders, non-responders had a longer total duration of fever and a higher incidence of coronary artery lesions. Prior to IVIG, non-responders had higher neutrophil differential and C-reactive protein, and lower cholesterol. 24 hours after the IVIG infusion, a total leucocyte count >13.1×10(9)/l, neutrophil differential >51% and total protein <72 g/l showed reasonable sensitivity (91%, 91% and 64%, respectively) and specificity (89%, 76% and 78%, respectively) as independent characteristics of non-response to IVIG. Laboratory parameters before and shortly after IVIG may reflect the severity of inflammation in KD patients and assist in informing further management.
منابع مشابه
Predictors of Intravenous Immunoglobulin (IVIG) Resistance in Children with Kawasaki Disease in Calabria Region, Italy
Background Kawasaki disease (KD) is the second most common childhood vasculitis and one of the main causes of acquired heart disease in children. Recent work focuses on the early diagnostic importance of those risk factors that indicate resistance to intravenous immunoglobulin (IVIG) treatment. The objectives of this study were to identify clinical, laboratory and/or instrumental factors that c...
متن کاملUse of Corticosteroid in Children with Unresponsiveness to Intravenous Immunoglobulin in Kawasaki Disease
Background Kawasaki Disease (KD) is a vasculitis with multi-organ involvementof unknown etiology; it is the most common cause of pediatric-heart diseases in developed countries. Treatment with Intravenous Immunoglobulin (IVIG) prevents coronary artery lesions; although there are some IVIG-resistant cases, combination therapy with corticosteroids and IVIG is one of the recommendations for treatm...
متن کاملبررسی فراوانی درگیری قلب در 61 کودک مبتلا به بیماری کاوازاکی
Kawasaki syndrome is an inflammatory multiorgan disease of unknown etiology. The most dramatic organ involved is the heart. There were a few studies about cardiac involvement in Iranian pediatric cases of Kawasaki disease. The aims of this study were determination of cardiac involvement prevalence in Iranian children with Kawasaki disease and its comparison with other studies. 61 pe...
متن کاملComparison of early and late intravenous gamma globulin treatment of Kawasaki disease on fever and cardiovascular complications
Background: Cardiac involvement was the major leading cause of death in patients with Kawasaki and IVIG administration reduces cardiac complications. The objective of this study was to determine the frequency of cardiovascular complications and duration of fever with regard to the time of intravenous immunoglobulin (IVIG) administration of patients with Kawasaki disease. Methods: This follow...
متن کاملCARDIAC SEQUELAE OF KAWASAKI DISEASE IN ISFAHAN, IRAN
Kawasaki disease is one of the major causes of acquired heart disease of children in developed countries. This study was performed to determine the frequency of cardiac sequelae of kawasaki disease and related risk factors based on a descriptive cross-sectional study between 1994-1999 in the pediatric ward of AI-Zahra Hospital of Isfahan. Out of 45 patients, 29 were male (64.4%) and 16 wer...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Archives of disease in childhood
دوره 96 11 شماره
صفحات -
تاریخ انتشار 2011