Novel Predictors of Intravenous Immunoglobulin Resistance in Chinese Children with Kawasaki Disease

Abstract

The new scoring system had a higher specificity and sensitivity for Chinese children, compared with the Kobayashi scoring system and the Egami scoring system, but, unfortunately, the new scoring system was not good enough to be widely used because of its low sensitivity.

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

“…risk prediction models for Asian populations are insufficiently accurate to be clinically useful in North American patients in predicting response to initial treatment with IVIG. 192,210 Better predictive models, perhaps incorporating biomarkers or genetic variants, will need to be developed for use outside Japan.…”

Predictors of intravenous immunoglobulin-resistant Kawasaki disease in children: a meta-analysis of 4442 cases

“…The results of 20 studies were combined in this study comprising 18 Asian studies [4, 6, 9, 10, 13, 17, 19, 20, 22, 24–26, 29, 32, 33, 37, 41, 44] and 2 North American studies [18, 38]. Each subgroup analysis showed the results had statistical significance; however, Baek et al [2] reported that ESR and platelet count could not predict IVIG-resistant Kawasaki disease from their statistical meta-analysis, which is contrary to the results of the present study.…”

“…Ram et al [34] found that prolonged fever, wider dispersion of symptoms, and pyuria were significantly associated with the development of coronary lesions, all of which the Kawasaki disease patients had. Choi et al [6] found that cervical lymphadenopathy is a risk factor for IVIG resistance, and Fu et al [13] believed that polymorphous rash and perianal change are risk factors for IVIG resistance. Yan et al [44] suggested that clinical features cannot predict IVIG-resistant Kawasaki disease; however, this study found that changes in oral mucosa, cervical lymphadenopathy, swelling of extremities, and polymorphous rash can predict IVIG-resistant Kawasaki disease, whereas conjunctival congestion cannot.…”

“…Japanese scholars Kobayashi et al [20], Sano et al [36], and Egami et al [11] summarized the standards for the prediction of IVIG-resistant Kawasaki disease; American scholars Tremoulet et al [42], Loomba et al [27], and Davies et al [7] also proposed a prediction system for the disease. At Beijing Children’s Hospital, Fu et al [13], Yan et al [44], and Choi et al [6] created a scoring system based on single-center research results. Although insightful, these prediction systems lacked unity.…”

Experience in the diagnosis and treatment of Kawasaki disease in the Saint-Petersburg State Pediatric Medical University Clinic and Saint Petersburg City Children’s Hospital One

“…Лабораторными предикторами резистентности к терапии ВВИГ и как следствие -более высокого риска развития коронарных аневризм являются нейтрофилез >80%, уровень тромбоцитов <300⋅10 9 /л, СРБ >100 мг/л, натрия <133 ммоль/л, АЛТ >100 Е/л [21], а также повы-шение уровня АСТ, общего билирубина, лактатдегидроге-назы [22], гамма-глутамилтрансферазы [23], анемия; ультразвуковые аномалии (водянка и холецистит) желч-ного пузыря [24]. В ряде публикаций такие клинические проявления, как шейная лимфаденопатия [25], поли-морфная экзантема и перианальные изменения [26], на-званы независимыми факторами риска резистентности к терапии ВВИГ.…”