Limitation of Prediction on Intravenous Immunoglobulin Responsiveness in Kawasaki Disease / 소아감염
Korean Journal of Pediatric Infectious Diseases
; : 169-176, 2010.
Article
Dans Ko
| WPRIM
| ID: wpr-219040
Responsable en Bibliothèque :
WPRO
ABSTRACT
PURPOSE:
We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls.METHODS:
We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders.RESULTS:
Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design.CONCLUSION:
Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Numération des plaquettes
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Immunoglobulines
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Sérumalbumine
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Lymphocytes
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Cholestérol
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Analyse multifactorielle
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Sensibilité et spécificité
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Immunoglobulines par voie veineuse
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Vaisseaux coronaires
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Fièvre
Type d'étude:
Diagnostic_studies
/
Prognostic_studies
Limites du sujet:
Humans
langue:
Ko
Texte intégral:
Korean Journal of Pediatric Infectious Diseases
Année:
2010
Type:
Article