Predictors for the first dose of immunoglobulin resistance in children with Kawasaki disease
- Author:
Lei MA
1
Author Information
- Publication Type:Journal Article
- Keywords: Immunoglobulin; Kawasaki disease; Predictor; Resistance
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2020;41(4):559-564
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the potential predictive factors for the first dose of intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease. Methods The clinical data of 301 children with KD were retrospectively analyzed. The children were divided into IVIG insensitive group and IVIG sensitive group. We compared the basic data and laboratory indexes in the two groups. The risk factors for IVIG resistance were determined by binary Logistic regression analysis and receiver operating characteristic (ROC) curves were constructed to determine the optimal predictive threshold value of the risk factors and the corresponding sensitivity and specificity. Results Neutrophil ratio (N%), basophil ratio (B%), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and procalcitonin (PCT) levels were higher in the IVIG insensitive group than in the IVIG sensitive group (P<0.05). However, lymphocyte ratio (L%), monocyte ratio (M%), hematocrit (HCT), mean erythrocyte hemoglobin (MCH), creatine kinase (CK), and sodium concentration (Na+) levels were lower than those in the IVIG sensitive group (P<0.05). Binary Logistic regression analysis showed that AST and PCT were independent risk factors for IVIG resistance. ROC curve was used to separately analyze AST and PCT's prediction of the occurrence of IVIG resistance. When AST was ≥29.5 U/L, the sensitivity and specificity for predicting IVIG resistance in children with KD were 91.7% and 64.4%, respectively, while when PCT was ≥1.70 ng/mL, the sensitivity and specificity for predicting IVIG resistance in KD were 91.7% and 62.3%, respectively. Conclusion AST and PCT can be used as potential predictors for IVIG resistance in KD.
