Ling Liu1,2, Wei Yin1,2, Ruigeng Wang1,2, Dongming Sun1,2, Xuelian He1,2, Yan Ding3,4. 1. Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China. 2. Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China. 3. Department of Rheumatology, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, 430016, China. dingyanrh@126.com. 4. Clinical Research Center, Wuhan Children's Hospital, No. 100 Hongkong Rd, Wuhan, China. dingyanrh@126.com.
Abstract
OBJECTIVE: We aimed to assess the prognostic role of liver function alteration with intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) by systematically analyzing and summarizing the results from published studies. METHODS: In this study, we summarized the evidence currently available up to March 31, 2015, and calculated the standard mean difference (SMD) of liver function parameters, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and total bilirubin between IVIG-responsive and IVIG-resistant patients. RESULTS: We found that the serum levels of these parameters in IVIG-non-responsive patients were significantly higher than that in IVIG-responsive group (total bilirubin: SMD = 0.984, 95%CI 0.712-1.184, p < 0.005; ALT: SMD = 0.555, 95%CI 0.400-0.710, p < 0.005; AST: SMD = 0.602, 95%CI 0.413-0.791, p < 0.005; GGT = 0.551, 95%CI 0.157-0.946, p = 0.006). There was evidence of heterogeneity (I (2) > 50%). The characteristics of patients could be the major sources, as analysis stratified by region significantly removed or reduced the heterogeneity. CONCLUSION: In summary, our meta-analysis suggested that liver abnormality was significantly associated with IVIG unresponsiveness in KD patients. Further study from more clinical investigations is needed to confirm this finding.
OBJECTIVE: We aimed to assess the prognostic role of liver function alteration with intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) by systematically analyzing and summarizing the results from published studies. METHODS: In this study, we summarized the evidence currently available up to March 31, 2015, and calculated the standard mean difference (SMD) of liver function parameters, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and total bilirubin between IVIG-responsive and IVIG-resistant patients. RESULTS: We found that the serum levels of these parameters in IVIG-non-responsive patients were significantly higher than that in IVIG-responsive group (total bilirubin: SMD = 0.984, 95%CI 0.712-1.184, p < 0.005; ALT: SMD = 0.555, 95%CI 0.400-0.710, p < 0.005; AST: SMD = 0.602, 95%CI 0.413-0.791, p < 0.005; GGT = 0.551, 95%CI 0.157-0.946, p = 0.006). There was evidence of heterogeneity (I (2) > 50%). The characteristics of patients could be the major sources, as analysis stratified by region significantly removed or reduced the heterogeneity. CONCLUSION: In summary, our meta-analysis suggested that liver abnormality was significantly associated with IVIG unresponsiveness in KDpatients. Further study from more clinical investigations is needed to confirm this finding.
Authors: Shohei Ogata; Chisato Shimizu; Alessandra Franco; Ranim Touma; John T Kanegaye; Biswa P Choudhury; Natasha N Naidu; Yutaka Kanda; Long T Hoang; Martin L Hibberd; Adriana H Tremoulet; Ajit Varki; Jane C Burns Journal: PLoS One Date: 2013-12-06 Impact factor: 3.240
Authors: Pamela Paglia; Lucia Nazzaro; Anna Giulia Elena De Anseris; Milena Lettieri; Rossella Colantuono; Maria Chiara Rocco; Maria Anna Siano; Nicola Biffaro; Pietro Vajro Journal: Pediatr Rep Date: 2021-07-01
Authors: Yue Wang; Zhen Li; Guang Hu; Shiying Hao; Xiaohong Deng; Min Huang; Miao Ren; Xiyuan Jiang; John T Kanegaye; Kee-Soo Ha; JungHwa Lee; Xiaofeng Li; Xuejun Jiang; Yunxian Yu; Adriana H Tremoulet; Jane C Burns; John C Whitin; Andrew Y Shin; Karl G Sylvester; Doff B McElhinney; Harvey J Cohen; Xuefeng B Ling Journal: PLoS One Date: 2016-12-21 Impact factor: 3.240