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标题:Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease
时间:2020-02-14 22:52:55
DOI:10.1016/j.jpeds.2006.03.050
作者:Kimiyasu Egami; Hiromi Muta; Masahiro Ishii
关键词:Regional integration
出版源: 《Journal of Pediatrics》 ,149 (2) :0-240
摘要:Objectives The objective of this study was to find the predictors and generate a prediction score of resistance to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD).Study design Patients diagnosed as having KD were sampled when they received initial high-dose IVIG treatment (2 g/kg dose) within 9 days of illness (n = 320). These patients were divided into 2 groups: the resistance (n = 41) and the responder (n = 279). The following data were obtained and compared between resistance and responder: age, sex, illness days at initial treatment, and laboratory data.Results Multivariate logistic regression analysis identified age, illness days, platelet count, alanine aminotransferase (ALT), and C-reactive protein (CRP) as significant predictors for resistance to IVIG. We generated prediction score assigning I point for (1) infants less than 6 months old, (2) before 4 days of illness, (3) platelet count <= 30 x 10(10)/L, (4) CRP >= 8 mg/dL, as well as 2 points for (5) ALT >= 80 IU/L. Using a cut-off point of 3 and more with this prediction score, we could identify the IVIG-resistant group with 78% sensitivity and 76% specificity.Conclusions Resistance to IVIG treatment can be predicted using age, illness days, platelet. count, ALT, and CRP. Randomized, multicenter clinical trials are necessary to create a new strategy to treat these high-risk patients.
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目录:
  • PREDICTION OF RESISTANCE TO INTRAVENOUS IMMUNOGLOBULIN TREATMENT IN PATIENTS WITH KAWASAKI DISEASE
    • METHODS
    • RESULTS
    • DISCUSSION
    • REFERENCES

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