Document Detail


Immunoglobulin G Values before Treatment Are Correlated With the Responsiveness to Initial Intravenous Immunoglobulin Therapy for Kawasaki Disease.
MedLine Citation:
PMID:  24903098     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Low levels of serum immunoglobulin G (IgG) before intravenous immunoglobulin (IVIG) therapy for Kawasaki disease (KD) have been reported as one of the risk factors for coronary artery abnormalities (CAAs). This risk factor needs to be re-evaluated because the dosage of IVIG has changed from 0.2-0.4 g/kg/day for 5 days to a single high dose of 2 g/kg. Methods: We reviewed the clinical records of KD patients admitted to our hospital from January 2001 to August 2011. Patients who were given a single high dose of IVIG within 7 days of illness, and who had blood collected for serum immunoglobulin values before treatment, were selected. The serum immunoglobulin levels and coronary artery diameters measured by echocardiogram were transformed to z-scores. Results: The subjects were 197 KD patients, including 22 IVIG nonresponders and 16 patients with CAAs. Of these, 150 (76%) had a z-score for IgG (IgGz) of ≤0. There were no differences in IgGz values between patients with CAAs and those without CAAs. However, nonresponders had higher IgGz values than responders (median, 25th percentile and 75th percentile: -0.26, -0.83 and 0.34 vs. -0.79, -1.40 and -0.03; p = 0.020). Logistic regression analysis showed that the IgGz value was an independent risk factor for resistance to IVIG (OR 1.36, 95% CI 1.002-1.849; p = 0.048). Conclusions: Low IgGz values were not a risk factor for CAAs in this study. However, KD patients with relatively high IgGz values before treatment may have an increased risk of resistance to initial IVIG therapy. © 2014 S. Karger AG, Basel.
Authors:
Kosuke Yanagimoto; Yuichi Nomura; Kiminori Masuda; Masako Hirabayashi; Yasuko Morita; Michiko Yoshishige; Kentaro Ueno; Taisuke Eguchi; Yoshifumi Kawano
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-4
Journal Detail:
Title:  International archives of allergy and immunology     Volume:  164     ISSN:  1423-0097     ISO Abbreviation:  Int. Arch. Allergy Immunol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211652     Medline TA:  Int Arch Allergy Immunol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  83-88     Citation Subset:  -    
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