Abstract 99: Retrospective Analysis of Kawasaki Disease Patients Resistant to Second Intravenous Immunoglobulin

Abstract

Objective: This retrospective analysis aimed to identify the risk factors of Kawasaki disease (KD) resistant to second intravenous immunoglobulin ( IVIG) and design the score system discerning IVIG resistant patients in acute phase. Materials and Methods: A retrospective chart review of pediatric patients admitted to Children’s Medical Center, Yokosuka General Hospital Uwamachi with the diagnosis of KD during 2011 to 2013. In total 127 patients, 116 patients received IVIG and of 92 patients were respondent for initial course of IVIG. Rest of 17 patients received second course of IVIG and of 7 patients were resistant to second course of IVIG. Results: Logistic regression analysis showed that serum sodium concentration <131 mEq/L (odds ratio[OR]=7.43, 95% confidence interval [CI]=1.470-37.564), serum albumin concentration <3.0 g/dl (OR=7.00, 95% CI=1.109-44.195), age less than six months (OR=8.25, 95% CI=1.615-42.146), and white blood cell count <9000/μ (OR=6.29, 95% CI=1.309-30.191) were associated with risk factors of resistant to second IVIG. Designed the score system on the basis of these four factors, we could estimate the failure to second IVIG and its accuracy was 95.3%. Conclusion: The score system based on easy and simple clinical factors might be useful for estimating the patients resistant to second IVIG and improve those patients’ further treatment.