PMID- 33753891
OWN - NLM
STAT- MEDLINE
DCOM- 20221229
LR  - 20221229
IS  - 1530-0447 (Electronic)
IS  - 0031-3998 (Linking)
VI  - 91
IP  - 3
DP  - 2022 Feb
TI  - Comparison of IVIG resistance predictive models in Kawasaki disease.
PG  - 621-626
LID - 10.1038/s41390-021-01459-w [doi]
AB  - BACKGROUND: We aimed to compare the ten different scores (by Kobayashi, Egami, 
      Harada, Formosa, Sano, Piram et al., Wu et al., Yang et al., Tan et al., and 
      Kanai et al.) to assess their performance in predicting IVIG resistance in 
      Turkish children. METHODS: Complete and incomplete KD patients diagnosed with KD 
      at Hacettepe University between June 2007 and September 2019 were evaluated 
      retrospectively. RESULTS: A total of 129 patients, 79 boys (61.2%), with a median 
      age 36 (IQR 19.5-57.0) months were evaluated. Sixteen patients (12.4%) had IVIG 
      resistance. Sensitivity was low for all the ten scores. Tan, Sano, and Egami 
      predictive models had the highest specificity (97.3, 89.4, 86.7%, respectively). 
      Almost all scoring systems distinguished the group of patients with low risk for 
      IVIG resistance but could not differentiate IVIG-resistant patients. Multivariate 
      analysis for the laboratory features showed that platelet count <300 x 10(9)/L 
      and GGT serum levels were independent risk factors for IVIG resistance (OR: 
      3.896; 95% CI: 1.054-14.404; p = 0.042 and OR: 1.008; 95% CI: 1.001-1.015; 
      p = 0.050). CONCLUSIONS: The current scoring systems had a low sensitivity for 
      predicting the risk for IVIG resistance in Turkish children. On the other hand, 
      increased serum GGT levels and low platelet count were risk factors for 
      predicting IVIG resistance. IMPACT: Intravenous immunoglobulin (IVIG) resistance 
      may be observed in 10-20% of patients diagnosed with Kawasaki disease. Coronary 
      artery involvement is more frequent in IVIG-resistant patients. It is important 
      to predict the patients who might develop IVIG resistance to improve prognosis. 
      The performance of the IVIG resistance predictive models in Kawasaki disease in 
      our population is limited due to the low sensitivity.
CI  - (c) 2021. The Author(s), under exclusive licence to the International Pediatric 
      Research Foundation, Inc.
FAU - Kaya Akca, Ummusen
AU  - Kaya Akca U
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Arslanoglu Aydin, Elif
AU  - Arslanoglu Aydin E
AD  - Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, 
      Turkey.
FAU - Aykan, Hayrettin Hakan
AU  - Aykan HH
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, 
      Hacettepe University, Ankara, Turkey.
FAU - Serin, Oguzhan
AU  - Serin O
AD  - Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, 
      Turkey.
FAU - Sag, Erdal
AU  - Sag E
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Demir, Selcan
AU  - Demir S
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Atalay, Erdal
AU  - Atalay E
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Kasap, Muserref
AU  - Kasap M
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Batu, Ezgi Deniz
AU  - Batu ED
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Karagoz, Tevfik
AU  - Karagoz T
AD  - Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, 
      Hacettepe University, Ankara, Turkey.
FAU - Bilginer, Yelda
AU  - Bilginer Y
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey.
FAU - Ozen, Seza
AU  - Ozen S
AD  - Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of 
      Medicine, Hacettepe University, Ankara, Turkey. sezaozen@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20210322
PL  - United States
TA  - Pediatr Res
JT  - Pediatric research
JID - 0100714
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adult
MH  - Child
MH  - Humans
MH  - Infant
MH  - Male
MH  - Drug Resistance
MH  - *Immunoglobulins, Intravenous/therapeutic use
MH  - *Mucocutaneous Lymph Node Syndrome/diagnosis/drug therapy
MH  - Retrospective Studies
MH  - Risk Assessment
EDAT- 2021/03/24 06:00
MHDA- 2022/04/12 06:00
CRDT- 2021/03/23 06:50
PHST- 2020/09/04 00:00 [received]
PHST- 2021/02/22 00:00 [accepted]
PHST- 2021/01/25 00:00 [revised]
PHST- 2021/03/24 06:00 [pubmed]
PHST- 2022/04/12 06:00 [medline]
PHST- 2021/03/23 06:50 [entrez]
AID - 10.1038/s41390-021-01459-w [pii]
AID - 10.1038/s41390-021-01459-w [doi]
PST - ppublish
SO  - Pediatr Res. 2022 Feb;91(3):621-626. doi: 10.1038/s41390-021-01459-w. Epub 2021 
      Mar 22.