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Randomized Controlled Trial
. 2011 May;158(5):831-835.e3.
doi: 10.1016/j.jpeds.2010.10.031. Epub 2010 Dec 18.

Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance

Lynn A Sleeper  1 , L Luann Minich, Brian M McCrindle, Jennifer S Li, Wilbert Mason, Steven D Colan, Andrew M Atz, Beth F Printz, Annette Baker, Victoria L Vetter, Jane W Newburger; Pediatric Heart Network Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance

Lynn A Sleeper et al. J Pediatr. 2011 May.

Abstract

Objectives: To assess the performance of 3 risk scores from Japan that were developed to predict, in children with Kawasaki disease, resistance to intravenous immunoglobulin (IVIG) treatment. VSports手机版.

Study design: We used data from a randomized trial of pulsed steroids for primary treatment of Kawasaki disease to assess operating characteristics of the 3 risk scores, and we examined whether steroid therapy lowers the risk of coronary artery abnormalities in patients prospectively classified as IVIG resistant V体育安卓版. .

Results: For comparability with published cohorts, we analyzed the data of 99 patients who were not treated with steroids (16% IVIG-retreated) and identified male sex, lower albumin level, and higher aspartate aminotransferase level as independent risk factors for IVIG resistance. The Kobayashi score was similar in IVIG-resistant and -responsive patients, yielding a sensitivity of 33% and specificity of 87% V体育ios版. There was no interaction of high-risk versus low-risk status by treatment received (steroid versus placebo) with any of the 3 risk score algorithms. .

Conclusion: Risk-scoring systems from Japan have good specificity but low sensitivity for predicting IVIG resistance in a North American cohort. Primary steroid therapy did not improve coronary outcomes in patients prospectively classified as being at high-risk for IVIG resistance VSports最新版本. .

Trial registration: ClinicalTrials. gov NCT00132080 V体育平台登录. .

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"V体育2025版" Conflict of interest statement

The authors declare no conflicts of interest..

Figures (V体育ios版)

Figure 1
Figure 1
Baseline-adjusted Treatment Effect Estimates and 95% Confidence Interval by Actual IVIG Retreatment Subgroup and by Estimated Kobayashi High vs. Low Risk Subgroup for Maximum Coronary Artery Z-score at One and Five Weeks Post-Randomization
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V体育2025版 - References

    1. Kobayashi T, Inoue Y, Takeuchi K, Okada Y, Tamura K, Tomomasa T, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation. 2006;113:2606–2612. - PubMed
    1. Sano T, Kurotobi S, Matsuzaki K, Yamamoto T, Maki I, Miki K, Kogaki S, Hara J. Predition of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment. Eur J Pediatr. 2007;166:131–137. - PubMed
    1. Egami K, Muta H, Ishii M, Suda K, Sugahara Y, Iemura M, Matsuishi T. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease. J Pediatr. 2006;149:237–240. - VSports在线直播 - PubMed
    1. Son MF, Gauvreau K, Ma L, Baker AL, Sundel RP, Fulton DR, Newburger JW. Diagnosis and treatment of Kawasaki Disease: Analysis of 27 U.S. pediatric hospitals from 2001–2006. Pediatrics. 2009;124:1–8. - PubMed
    1. Burns JC, Capparelli EV, Brown JA, Newburger JW, Glode MP. Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J. 1998 Dec;17:1144–1148. - PubMed (V体育ios版)

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