Noboru Yamamoto1,2, Kaoru Sato1, Takayuki Hoshina2, Masumi Kojiro1, Koichi Kusuhara2. 1. a Department of Pediatrics , Kitakyushu General Hospital , Kitakyushu , Japan. 2. b Department of Pediatrics , School of Medicine, University of Occupational and Environmental Health , Kitakyushu , Japan.
Abstract
OBJECTIVES: The aim of this study is to investigate whether ferritin can be a useful marker for the prediction of the patients with Kawasaki disease (KD) refractory to initial intravenous immunoglobulin (IVIG) therapy. METHODS: This retrospective study enrolled 85 patients with KD hospitalized at Kitakyushu General Hospital during 2010-2014. These patients were divided into IVIG responders (n = 57) and non-responders (n = 28). Serum ferritin levels and the scoring systems for the prediction of non-responsiveness to initial IVIG therapy were compared between these two groups. RESULTS: Serum ferritin level was significantly elevated in non-responders (p = 0.010). The area under the receiver-operating characteristics curve was 0.674, and the sensitivity and specificity in more than 165 ng/ml of serum ferritin level were 70.4% and 63.2%, respectively. In two of the three prediction scoring systems, non-responders also showed significantly higher scores than responders, but many non-responders had low scores of these scoring systems. More than half of the patients with a low score of these scoring systems had high serum ferritin level (≥ 165 ng/ml). CONCLUSIONS: Serum ferritin level might be a useful marker for the prediction of non-responsiveness to initial IVIG therapy and could be an important complementary marker to the prediction scoring systems.
OBJECTIVES: The aim of this study is to investigate whether ferritin can be a useful marker for the prediction of the patients with Kawasaki disease (KD) refractory to initial intravenous immunoglobulin (IVIG) therapy. METHODS: This retrospective study enrolled 85 patients with KD hospitalized at Kitakyushu General Hospital during 2010-2014. These patients were divided into IVIG responders (n = 57) and non-responders (n = 28). Serum ferritin levels and the scoring systems for the prediction of non-responsiveness to initial IVIG therapy were compared between these two groups. RESULTS: Serum ferritin level was significantly elevated in non-responders (p = 0.010). The area under the receiver-operating characteristics curve was 0.674, and the sensitivity and specificity in more than 165 ng/ml of serum ferritin level were 70.4% and 63.2%, respectively. In two of the three prediction scoring systems, non-responders also showed significantly higher scores than responders, but many non-responders had low scores of these scoring systems. More than half of the patients with a low score of these scoring systems had high serum ferritin level (≥ 165 ng/ml). CONCLUSIONS: Serum ferritin level might be a useful marker for the prediction of non-responsiveness to initial IVIG therapy and could be an important complementary marker to the prediction scoring systems.
Authors: Cristina O Mărginean; Lorena E Meliț; Liliana Gozar; Cristian Dan Mărginean; Maria O Mărginean Journal: Front Pediatr Date: 2018-07-27 Impact factor: 3.418
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