PMID- 36156791 OWN - NLM STAT- MEDLINE DCOM- 20221026 LR - 20221026 IS - 1179-2019 (Electronic) IS - 1174-5878 (Print) IS - 1174-5878 (Linking) VI - 24 IP - 6 DP - 2022 Nov TI - High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis. PG - 689-697 LID - 10.1007/s40272-022-00537-8 [doi] AB - BACKGROUND: Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever >/=36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This study aimed to determine the independent association between increased IVIG resistance and 10% IVIG therapy. METHODS: Medical records of pediatric patients with KD were retrospectively reviewed. Clinical and laboratory characteristics were compared between patients receiving 5% IVIG therapy and those receiving 10% IVIG therapy. Between IVIG-responsive and IVIG-resistant patients, a multivariate analysis was performed to determine the independent factors for IVIG resistance. RESULTS: A total of 119 patients were included in this study: 81 (68.1%) and 38 (31.9%) patients received 5% and 10% IVIG therapy, respectively. IVIG resistance was identified in 34 (28.6%) patients: 44.7% of patients receiving 10% IVIG therapy and 21.0% of patients receiving 5% IVIG therapy (p = 0.008). The clinical manifestations and outcomes were comparable between patients who received 5% IVIG therapy and those who received 10% IVIG therapy. IVIG resistance was significantly associated with fewer fever days at IVIG administration (p = 0.032), a higher percentage of neutrophils (p = 0.013), and 10% IVIG treatment (p = 0.004) in the multivariate analysis. CONCLUSION: 10% IVIG therapy was significantly associated with increased reporting of IVIG resistance. However, the increase in patients with fever patterns consistent with IVIG resistance seemed to represent adverse febrile reactions resulting from using high-concentration IVIG rather than increased severity of KD. CI - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG. FAU - Han, Seung Beom AU - Han SB AUID- ORCID: 0000-0002-1299-2137 AD - Department of Pediatrics, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea. FAU - Suh, Woosuck AU - Suh W AUID- ORCID: 0000-0002-7730-5772 AD - Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea. AD - Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Rhim, Jung-Woo AU - Rhim JW AUID- ORCID: 0000-0002-0227-3809 AD - Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea. jwrhim@catholic.ac.kr. AD - Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. jwrhim@catholic.ac.kr. LA - eng PT - Journal Article DEP - 20220926 PL - Switzerland TA - Paediatr Drugs JT - Paediatric drugs JID - 100883685 RN - 0 (Immunoglobulins, Intravenous) SB - IM MH - Humans MH - Child MH - Infant MH - *Mucocutaneous Lymph Node Syndrome/drug therapy MH - Immunoglobulins, Intravenous/adverse effects MH - Retrospective Studies MH - Fever/drug therapy PMC - PMC9510556 COIS- All authors had no conflict of interest. EDAT- 2022/09/27 06:00 MHDA- 2022/10/27 06:00 PMCR- 2022/09/26 CRDT- 2022/09/26 16:51 PHST- 2022/09/04 00:00 [accepted] PHST- 2022/09/27 06:00 [pubmed] PHST- 2022/10/27 06:00 [medline] PHST- 2022/09/26 16:51 [entrez] PHST- 2022/09/26 00:00 [pmc-release] AID - 10.1007/s40272-022-00537-8 [pii] AID - 537 [pii] AID - 10.1007/s40272-022-00537-8 [doi] PST - ppublish SO - Paediatr Drugs. 2022 Nov;24(6):689-697. doi: 10.1007/s40272-022-00537-8. Epub 2022 Sep 26.