Analysis of risk factors with refractory Kawasaki disease to gamma-globulin therapy

Abstract

Abstract: AIM: To investigate the incidence and risk factors of children with refractory Kawasaki disease (KD). METHODS: Clinical data of KD patients hospitalized in the Second Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2010 were summarized.Refractory KD was defined as those who remained febrile with a temperature of > 38.5 ℃ for 36 hours after initial intravenous immunoglobulin treatment. All KD patients were divided into two groups, responsiveness group and non-responsiveness group,based on their response to the first high dose IVIG therapy. RESULTS: Total 515 KD patients treated with high dose IVIG were included.The incidence of non-responsiveness to IVIG therapy is 7.57% (39/515). Logistic regression revealed that white blood cell(WBC), hemoglobin,C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), alanine aminotransferase (ALT), serum albumin and IVIG dosage were independent risk factors for refractory KD(P<0.05). CONCLUSION: The incidence of refractory KD is 7.57%. WBC, hemoglobin, CRP, ESR,ALT, serum albumin and IVIG dosage can predict the occurrence of refractory KD.

Key words: Kawasaki disease, Gamma globulin, Intravenous injection, Non-responsiveness, Risk factor

CLC Number:

R543.6

ZHANG Song-yue, ZHANG Yuan-hai, RONG Xing, REN Yue, CHEN Qi, XIANG Ru-lian. Analysis of risk factors with refractory Kawasaki disease to gamma-globulin therapy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(6): 657-660.

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