PMID- 33694279 OWN - NLM STAT- MEDLINE DCOM- 20211004 LR - 20211004 IS - 1399-3038 (Electronic) IS - 0905-6157 (Print) IS - 0905-6157 (Linking) VI - 32 IP - 6 DP - 2021 Aug TI - Predictive value of coagulation profiles for both initial and repeated immunoglobulin resistance in Kawasaki disease: A prospective cohort study. PG - 1349-1359 LID - 10.1111/pai.13495 [doi] AB - BACKGROUND: Intravenous immunoglobulin (IVIG) resistance prediction remains substantial in Kawasaki disease (KD), with limited data on the predictive value of coagulation profile for IVIG resistance, particularly for repeated IVIG resistance. Therefore, the aim of our study was to testify the predictive validity of coagulation profile for both initial IVIG resistance and repeated IVIG resistance in KD. METHODS: A total of 385 KD patients were prospectively recruited between April 2015 and May 2019. Coagulation and other profiles were evaluated between the IVIG-responsive and IVIG-resistant groups. Multivariate logistic regression analysis was applied to determine the association between coagulation profiles and IVIG resistance. ROC curves analysis was further performed to assess the validity of coagulation profiles in predicting both initial IVIG resistance and repeated IVIG resistance. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen degradation products (FDPs), and D-dimer were significantly increased in the initial IVIG-resistant group with antithrombin III (ATIII) and thrombin time (TT) significantly reduced. Meanwhile, ATIII was declined markedly in repeated IVIG-resistant patients. Multivariate logistic regression analysis showed that PT, APTT, D-dimer, and ATIII were independent risk factors for predicting initial IVIG resistance and ATIII for predicting repeated IVIG-resistant patients with KD. PT, APTT, D-dimer, and ATIII cutoff values of 13.95 s, 41.15 s, 1.48 mg/L, and 89.5% yielded sensitivities of 73%, 32%, 71%, and 81%, and specificities of 55%, 88%, 62%, and 51% for predicting initial IVIG resistance, respectively. The cutoff value of ATIII for predicting repeated IVIG resistance was 68.5%, with sensitivity of 71% and specificity of 55%. CONCLUSIONS: KD patients who have hypercoagulation during the acute phase might be at higher risk of developing IVIG resistance. CI - (c) 2021 The Authors. Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. FAU - Shao, Shuran AU - Shao S AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Yang, Lixia AU - Yang L AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Liu, Xiaoliang AU - Liu X AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Liu, Lei AU - Liu L AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - West China Medical School of Sichuan University, Chengdu, China. FAU - Wu, Mei AU - Wu M AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Deng, Yuxin AU - Deng Y AD - Wenzhou Medical University, Wenzhou, China. FAU - Duan, Hongyu AU - Duan H AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Li, Yifei AU - Li Y AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Hua, Yimin AU - Hua Y AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Luo, Lili AU - Luo L AD - Department of Pediatric intensive care unit, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Zhou, Kaiyu AU - Zhou K AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. FAU - Wang, Chuan AU - Wang C AUID- ORCID: 0000-0001-5165-8273 AD - Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, China. AD - The Cardiac Development and Early Intervention Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China. AD - Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210320 PL - England TA - Pediatr Allergy Immunol JT - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JID - 9106718 RN - 0 (Immunoglobulins, Intravenous) SB - IM MH - Humans MH - Immunoglobulins, Intravenous/therapeutic use MH - *Mucocutaneous Lymph Node Syndrome/diagnosis/drug therapy MH - Prospective Studies MH - ROC Curve MH - Retrospective Studies PMC - PMC8451858 OTO - NOTNLM OT - Antithrombin III OT - coagulation profile OT - immunoglobulin resistance OT - kawasaki disease OT - prediction COIS- The authors have no conflicts of interest to disclose. EDAT- 2021/03/12 06:00 MHDA- 2021/10/05 06:00 PMCR- 2021/09/20 CRDT- 2021/03/11 07:22 PHST- 2021/02/28 00:00 [revised] PHST- 2020/10/21 00:00 [received] PHST- 2021/03/05 00:00 [accepted] PHST- 2021/03/12 06:00 [pubmed] PHST- 2021/10/05 06:00 [medline] PHST- 2021/03/11 07:22 [entrez] PHST- 2021/09/20 00:00 [pmc-release] AID - PAI13495 [pii] AID - 10.1111/pai.13495 [doi] PST - ppublish SO - Pediatr Allergy Immunol. 2021 Aug;32(6):1349-1359. doi: 10.1111/pai.13495. Epub 2021 Mar 20.