Predictors of intravenous immunoglobulin resistance in Kawasaki disease in a tertiary children&rsquo;s hospital

Leah Patricia  M. Arceo-Plucena,; Chrys Kristofferson  P. Aguilera,

Predictors of intravenous immunoglobulin resistance in Kawasaki disease in a tertiary children’s hospital

Chrys Kristofferson P. Aguilera | Leah Patricia M. Arceo-Plucena

Abstract:

BACKGROUND AND OBJECTIVE: Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed countries. We aimed to determine the predictors of intravenous immunoglobulin (IVIG) resistance based on clinical manifestations and laboratory parameters. METHODOLOGY: This was a retrospective cohort study of classic KD patients. RESULTS: Two hundred and ten patients were included in the study. The mean age was 2.0 1.8 years old with slight female predominance at 51.4%. Seven (3.3%) cases were found to be IVIG resistant. There was no significant difference in age, clinical manifestations or fever duration. Univariate analysis revealed that IVIG resistant group had a heavier weight with mean of 16.4 kg 12.2 compared to the IVIG responder group 12.2kg 4.8. The IVIG resistant group had a higher white blood cell count of 23.9 7.8 compared to the responder group of 17.9 6.5. CONCLUSION ANDRECOMMENDATIONS: There is an IVIG resistance rate of 3.3% among classic KD patients. A high white blood cell count and weight are probable predictors for IVIG resistant KD. We recommend a larger sample size of resistant cases and a case-control multicenter study.

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