Assessment of intravenous immunoglobulin non-responders in Kawasaki disease

Arch Dis Child. 2011 Nov;96(11):1088-90. doi: 10.1136/adc.2010.184101. Epub 2010 Jun 15.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Child, Preschool
  • Cholesterol / blood
  • Coronary Disease / etiology
  • Female
  • Fever / etiology
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / therapeutic use*
  • Infant
  • Leukocyte Count
  • Male
  • Mucocutaneous Lymph Node Syndrome / blood
  • Mucocutaneous Lymph Node Syndrome / complications
  • Mucocutaneous Lymph Node Syndrome / therapy*
  • Neutrophils / pathology
  • Prospective Studies
  • Risk Factors
  • Treatment Failure

Substances

  • Biomarkers
  • Immunoglobulins, Intravenous
  • C-Reactive Protein
  • Cholesterol