OBJECTIVES: To explore the increased incidence of intravenous immunoglobulin- (IVIG) resistance among San Diego County patients with Kawasaki disease (KD) in 2006 and to evaluate a scoring system to predict IVIG-resistant patients with KD. STUDY DESIGN: We performed a retrospective review of patients with KD treated within 10 days of fever onset. With multivariate analysis, independent predictors of IVIG-resistance were combined into a scoring system. RESULTS: In 2006, 38.3% of patients with KD in San Diego County were IVIG-resistant, a significant increase over previous years. IVIG-resistance was not associated with a particular brand or lot of IVIG. Resistant patients were diagnosed earlier, had higher percent bands, and higher concentrations of C-reactive protein, alanine aminotransferase, and gamma-glutamyl transferase. They also had lower platelet counts and age-adjusted hemoglobin concentrations and were more likely to have aneurysms (P = .0008). A scoring system developed to predict IVIG-resistant patients using illness day, percent bands, gamma-glutamyl transferase, and age-adjusted hemoglobin had a sensitivity of 73.3% and specificity of 61.9%. CONCLUSIONS: An unexplained increase in IVIG-resistance was noted among patients with KD in San Diego County in 2006. Scoring systems based on demographic and laboratory data were insufficiently accurate to be clinically useful in our ethnically diverse population.
OBJECTIVES: To explore the increased incidence of intravenous immunoglobulin- (IVIG) resistance among San Diego County patients with Kawasaki disease (KD) in 2006 and to evaluate a scoring system to predict IVIG-resistant patients with KD. STUDY DESIGN: We performed a retrospective review of patients with KD treated within 10 days of fever onset. With multivariate analysis, independent predictors of IVIG-resistance were combined into a scoring system. RESULTS: In 2006, 38.3% of patients with KD in San Diego County were IVIG-resistant, a significant increase over previous years. IVIG-resistance was not associated with a particular brand or lot of IVIG. Resistant patients were diagnosed earlier, had higher percent bands, and higher concentrations of C-reactive protein, alanine aminotransferase, and gamma-glutamyl transferase. They also had lower platelet counts and age-adjusted hemoglobin concentrations and were more likely to have aneurysms (P = .0008). A scoring system developed to predict IVIG-resistant patients using illness day, percent bands, gamma-glutamyl transferase, and age-adjusted hemoglobin had a sensitivity of 73.3% and specificity of 61.9%. CONCLUSIONS: An unexplained increase in IVIG-resistance was noted among patients with KD in San Diego County in 2006. Scoring systems based on demographic and laboratory data were insufficiently accurate to be clinically useful in our ethnically diverse population.
Authors: J W Newburger; M Takahashi; A S Beiser; J C Burns; J Bastian; K J Chung; S D Colan; C E Duffy; D R Fulton; M P Glode Journal: N Engl J Med Date: 1991-06-06 Impact factor: 91.245
Authors: Jane C Burns; Wilbert H Mason; Sarmistha B Hauger; Hillel Janai; John F Bastian; Julie D Wohrley; Ian Balfour; Cynthia A Shen; Edward D Michel; Stanford T Shulman; Marian E Melish Journal: J Pediatr Date: 2005-05 Impact factor: 4.406
Authors: Chiea Chuen Khor; Sonia Davila; Willemijn B Breunis; Yi-Ching Lee; Chisato Shimizu; Victoria J Wright; Rae S M Yeung; Dennis E K Tan; Kar Seng Sim; Jie Jin Wang; Tien Yin Wong; Junxiong Pang; Paul Mitchell; Rolando Cimaz; Nagib Dahdah; Yiu-Fai Cheung; Guo-Ying Huang; Wanling Yang; In-Sook Park; Jong-Keuk Lee; Jer-Yuarn Wu; Michael Levin; Jane C Burns; David Burgner; Taco W Kuijpers; Martin L Hibberd Journal: Nat Genet Date: 2011-11-13 Impact factor: 38.330
Authors: Lori B Daniels; Matthew S Tjajadi; Hannah H Walford; Susan Jimenez-Fernandez; Vera Trofimenko; Daryl B Fick; Hoang-Anh L Phan; Peter E Linz; Keshav Nayak; Andrew M Kahn; Jane C Burns; John B Gordon Journal: Circulation Date: 2012-05-17 Impact factor: 29.690