Predicting Factors for Refractory Kawasaki Disease.
10.4070/kcj.2010.40.5.239
- Author:
Young Sun DO
1
;
Ki Won KIM
;
Jin Kyong CHUN
;
Byung Ho CHA
;
Mee Kyung NAMGOONG
;
Hae Yong LEE
Author Information
1. Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. reehy@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Mucocutaneous Lymph Node Syndrome;
Risk factors;
Coronary arteries
- MeSH:
Coronary Vessels;
Dilatation;
Humans;
Immunoglobulins;
Lymphocytes;
Mucocutaneous Lymph Node Syndrome;
Neutrophils;
Retrospective Studies;
Risk Factors;
Sodium;
Urinary Tract Infections
- From:Korean Circulation Journal
2010;40(5):239-242
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: About 10-15% of Kawasaki disease (KD) is refractory to intravenous immunoglobulin (IVIG) therapy. This study was designed to investigate the predicting factors for refractory KD. SUBJECTS AND METHODS: We reviewed retrospectively the clinical records of 77 patients with typical KD admitted at Wonju Christian Hospital from January, 2005, to December, 2008. The variance of laboratory and demographic parameters between the IVIG-responsive group and IVIG-resistant group were analyzed. Thirteen patients with urinary tract infections were randomly collected as a febrile control group. RESULTS: Among 77 patients diagnosed with complete KD, 13 patients (16.9%) were IVIG-resistant. The febrile period and hospital days were significantly longer in the IVIG-resistant group than IVIG-responsive group (p<0.001, p=0.002). Serum levels of albumin and sodium were significantly lower in the IVIG-resistant group (p=0.025). The Kobayashi score could differentiate these two groups (p=0.015). Fewer lymphocytes was observed during the subacute phase in the IVIG-resistant group (p=0.032). Coronary arterial dilatations (CADs) were observed in 10.9% (7/64) of IVIG-responders and 38.5% (5/13) of IVIG-resistant patients (p=0.038). CONCLUSION: The percentage of neutrophils and lymphocytes in patients with KD, in addition to known risk factors for refractory KD, may help predict IVIG-resistance in patients with KD.
