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Assessment of intravenous immunoglobulin non-responders in Kawasaki disease
  1. Ja-Young Hwang1,
  2. Kyung-Yil Lee1,
  3. Jung-Woo Rhim1,
  4. You-Sook Youn1,
  5. Jin-Hee Oh1,
  6. Ji-Whan Han1,
  7. Joon-Sung Lee1,
  8. David Burgner2,3
  1. 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
  2. 2Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia
  3. 3School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
  1. Correspondence to Dr Kyung-Yil Lee, Department of Pediatrics, The Catholic University of Korea, Daejeon St Mary's Hospital, 520-2 Daeheung-dong, Jung-gu, Daejeon 301–723, South Korea; leekyungyil{at}catholic.ac.kr

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 >13.1×109/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.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics committee approval was obtained from the Institutional Review Board of The Catholic University of Korea, Daejeon St Mary's Hospital, Daejeon, South Korea.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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