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Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance.

Publication ,  Journal Article
Sleeper, LA; Minich, LL; McCrindle, BM; Li, JS; Mason, W; Colan, SD; Atz, AM; Printz, BF; Baker, A; Vetter, VL; Newburger, JW ...
Published in: J Pediatr
May 2011

OBJECTIVES: To assess the performance of 3 risk scores from Japan that were developed to predict, in children with Kawasaki disease, resistance to intravenous immunoglobulin (IVIG) treatment. STUDY DESIGN: We used data from a randomized trial of pulsed steroids for primary treatment of Kawasaki disease to assess operating characteristics of the 3 risk scores, and we examined whether steroid therapy lowers the risk of coronary artery abnormalities in patients prospectively classified as IVIG resistant. RESULTS: For comparability with published cohorts, we analyzed the data of 99 patients who were not treated with steroids (16% IVIG-retreated) and identified male sex, lower albumin level, and higher aspartate aminotransferase level as independent risk factors for IVIG resistance. The Kobayashi score was similar in IVIG-resistant and -responsive patients, yielding a sensitivity of 33% and specificity of 87%. There was no interaction of high-risk versus low-risk status by treatment received (steroid versus placebo) with any of the 3 risk score algorithms. CONCLUSION: Risk-scoring systems from Japan have good specificity but low sensitivity for predicting IVIG resistance in a North American cohort. Primary steroid therapy did not improve coronary outcomes in patients prospectively classified as being at high-risk for IVIG resistance.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2011

Volume

158

Issue

5

Start / End Page

831 / 835.e3

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • ROC Curve
  • Prognosis
  • Pediatrics
  • Mucocutaneous Lymph Node Syndrome
  • Male
  • Infusions, Intravenous
  • Infant
  • Immunologic Factors
 

Citation

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Sleeper, L. A., Minich, L. L., McCrindle, B. M., Li, J. S., Mason, W., Colan, S. D., … Pediatric Heart Network Investigators, . (2011). Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance. J Pediatr, 158(5), 831-835.e3. https://doi.org/10.1016/j.jpeds.2010.10.031
Sleeper, Lynn A., L Luann Minich, Brian M. McCrindle, Jennifer S. Li, Wilbert Mason, Steven D. Colan, Andrew M. Atz, et al. “Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance.J Pediatr 158, no. 5 (May 2011): 831-835.e3. https://doi.org/10.1016/j.jpeds.2010.10.031.
Sleeper LA, Minich LL, McCrindle BM, Li JS, Mason W, Colan SD, et al. Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance. J Pediatr. 2011 May;158(5):831-835.e3.
Sleeper, Lynn A., et al. “Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance.J Pediatr, vol. 158, no. 5, May 2011, pp. 831-835.e3. Pubmed, doi:10.1016/j.jpeds.2010.10.031.
Sleeper LA, Minich LL, McCrindle BM, Li JS, Mason W, Colan SD, Atz AM, Printz BF, Baker A, Vetter VL, Newburger JW, Pediatric Heart Network Investigators. Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance. J Pediatr. 2011 May;158(5):831-835.e3.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2011

Volume

158

Issue

5

Start / End Page

831 / 835.e3

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • ROC Curve
  • Prognosis
  • Pediatrics
  • Mucocutaneous Lymph Node Syndrome
  • Male
  • Infusions, Intravenous
  • Infant
  • Immunologic Factors