| External validation of a risk score to predict intravenous immunoglobulin resistance in patients with kawasaki disease. | |
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MedLine Citation:
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PMID: 20802375 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: we previously developed a new risk score to predict intravenous immunoglobulin (IVIG) resistance in Kawasaki disease. However, the IVIG dosage used in that study (1 g/kg/d for 2 consecutive days) differs from the single infusion of 2 g/kg recommended in the United States and elsewhere. Our aim was to assess the validity and applicability of our risk score in patients treated with a single infusion. METHODS: we used a database of 1626 patients with Kawasaki disease given initial IVIG treatment at a dose of 1 g/kg/d for 2 consecutive days (n = 990; IVIG- 1 g/kg × 2) or 2 g/kg/d for 1 day (n = 636; IVIG- 2 g/kg × 1) across 17 hospitals in Japan. Patients received the total IVIG dose within 36 hours in IVIG- 1 g/kg × 2 and 24 hours in IVIG- 2 g/kg × 1. We stratified the patients according to a risk scoring system developed to predict IVIG unresponsiveness, based on scores of ≥ 5 points. We compared the accuracy of prediction between the 2 groups using receiver operating characteristic analysis. RESULTS: baseline characteristics and clinical outcomes were similar between both groups. The areas under the receiver operating characteristic curve in IVIG- 2 g/kg × 1 were similar to those of IVIG- 1 g/kg × 2. Using a cut-off risk score of ≥ 5 points, we could identify IVIG resistance in terms of coronary artery abnormalities within 1 month and coronary artery abnormalities at 1 month with equivalent sensitivity and specificity in both groups. CONCLUSION: our risk score can be used to predict IVIG unresponsiveness to a regimen based on a single infusion of 2 g/kg IVIG. |
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Authors:
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Mitsuru Seki; Tohru Kobayashi; Tomio Kobayashi; Akihiro Morikawa; Tetsuya Otani; Kazuo Takeuchi; Mamoru Ayusawa; Keiji Tsuchiya; Kenji Yasuda; Takahiro Suzuki; Shinya Shimoyama; Kentaro Ikeda; Yoichiro Ishii; Hirokazu Arakawa |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Pediatric infectious disease journal Volume: 30 ISSN: 1532-0987 ISO Abbreviation: Pediatr. Infect. Dis. J. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701858 Medline TA: Pediatr Infect Dis J Country: United States |
Other Details:
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Languages: eng Pagination: 145-7 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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