Predicting IVIG resistance in UK Kawasaki disease

Sarah Davies; Natalina Sutton; Sarah Blackstock; Stuart Gormley; Clive J. Hoggart; Michael Levin; Jethro A. Herberg

doi:10.1136/archdischild-2014-307397

Predicting IVIG resistance in UK Kawasaki disease

Sarah Davies, Natalina Sutton, Sarah Blackstock, Stuart Gormley, Clive J. Hoggart, Michael Levin, Jethro A. Herberg

Research output: Contribution to journal › Article › peer-review

97 Scopus citations

Abstract

The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.

Original language	English
Pages (from-to)	366-368
Number of pages	3
Journal	Archives of Disease in Childhood
Volume	100
Issue number	4
DOIs	https://doi.org/10.1136/archdischild-2014-307397
State	Published - 1 Apr 2015
Externally published	Yes

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title = "Predicting IVIG resistance in UK Kawasaki disease",

abstract = "The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.",

author = "Sarah Davies and Natalina Sutton and Sarah Blackstock and Stuart Gormley and Hoggart, {Clive J.} and Michael Levin and Herberg, {Jethro A.}",

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doi = "10.1136/archdischild-2014-307397",

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T1 - Predicting IVIG resistance in UK Kawasaki disease

AU - Davies, Sarah

AU - Sutton, Natalina

AU - Blackstock, Sarah

AU - Gormley, Stuart

AU - Hoggart, Clive J.

AU - Levin, Michael

AU - Herberg, Jethro A.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.

AB - The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.

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JO - Archives of Disease in Childhood

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Predicting IVIG resistance in UK Kawasaki disease

Abstract

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