Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder

Pediatrics International, 04/27/2012

Nomura Y et al. – The number of principal symptoms before treatment is a useful guide to Kawasaki disease (KD) disease severity. Six–symptom patients have a higher risk of being a non–responder than five–symptom patients.

Methods

  • Patients with definite KD or suspicion of KD were retrospectively examined.
  • Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non-responders) were compared between patients with six principal symptoms, including fever of 4 days, before treatment of KD (six-symptom patients), and those with five or fewer symptoms (five-symptom patients).

Results

  • The study group of 207 patients who were treated with immunoglobulin consisted of 121 six-symptom patients and 86 five-symptom patients.
  • The six-symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five-symptom patients.
  • Although the treatments did not differ between the groups, the six-symptom patients had a higher incidence of non-responders than the five-symptom patients (17% vs 5%; P= 0.008).
  • Logistic regression analysis showed that six-symptom status was related to the risk of being a non-responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6–17.4).

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