Serum albumin level predicts initial intravenous immunoglobulin treatment failure in Kawasaki disease

@article{Kuo2010SerumAL,
  title={Serum albumin level predicts initial intravenous immunoglobulin treatment failure in Kawasaki disease},
  author={Ho‐Chang Kuo and C D Liang and Chih-Lu Wang and Hong-Ren Yu and Kao-Pin Hwang and Kuender D Yang},
  journal={Acta P{\ae}diatrica},
  year={2010},
  volume={99}
}
Objectives:  Kawasaki disease (KD) is a systemic vasculitis primarily affecting children who are <5 years old. Intravenous immunoglobulin (IVIG) is the standard therapy for KD. However, many patients with KD still show poor response to initial IVIG treatment. This study was conducted to investigate the risk factors for initial IVIG treatment failure in KD. 
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TLDR
The strategy on prediction of potentially non responder and treatment of intravenous immunoglobin resistant patients is now controversial but some useful points were recommended.
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Kawasaki disease shock syndrome (KDSS) is an uncommon presentation of Kawasaki disease (KD). KDSS has been associated with more severe markers of inflammation, coronary abnormalities and i.v.
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TLDR
The supplementary criteria for incomplete presentation of KD patients suggested by the American Heart Association, treatment for those with intravenous immunoglobulin treatment failure, and other experiences are included in this review.
Kawasaki disease: current aspects on aetiopathogenesis and therapeutic management.
TLDR
The management of the disease is divided according to the clinical stage and patients' follow up should be continued for years after the disease onset, determined by the risk level of the KD.
Predictors of Intravenous Immunoglobulin Resistance in Chinese Children with Kawasaki Disease
TLDR
Low serum albumin level and high neutrophil percentage were independent predictors of IVIG resistance in Chinese children with Kawasaki Disease.
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TLDR
Elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with Kawasaki disease, according to two independent predictors confirmed through multivariate logistic regression analysis.
High-Dose Aspirin Is Associated with Anemia and Does Not Confer Benefit to Disease Outcomes in Kawasaki Disease
TLDR
Examination of treatment efficacy, degree of anemia and inflammation, and changes in serum hepcidin in children who received a combination of high-dose aspirin and IVIG in the acute stage of KD, and those who received IVIG alone provides evidence demonstrating that high- doses of aspirin do not confer any benefit with regards to inflammation and it does not appear to improve treatment outcomes.
Risk Factors of Intravenous Immunoglobulin Resistance in Children With Kawasaki Disease: A Meta-Analysis of Case-Control Studies
TLDR
A meta-analysis found that in addition to patients with polymorphous rash or swelling of extremities symptoms had a tendency to be non-responders, IVIG resistance was more likely to occur in patients with severe anemia, hypoalbuminemia, decreased baseline platelet count, and elevated levels of erythrocyte sedimentation rate (ESR).
Risk factors and derived formosa score for intravenous immunoglobulin unresponsiveness in Taiwanese children with Kawasaki disease.
TLDR
A simple three-variable Formosa score for KD patients is established to identify early those at risk of IVIG unresponsiveness for timely aggressive immunomodulation initially.
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