Procalcitonin levels predicting the infliximab response of immunoglobulin resistant Kawasaki disease
| Autor: | Shouichi Ohga, Kiyoshi Uike, Hazumu Nagata, Hidetoshi Takada, Eiko Terashi, Eiji Morihana, Etsuro Nanishi, Kenichiro Yamamura, Yasutaka Nakashima, Satoshi Honjo, Tamami Tanaka, Yuichiro Hirata |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases 0301 basic medicine medicine.medical_specialty Immunology Mucocutaneous Lymph Node Syndrome Biochemistry Gastroenterology Procalcitonin 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Immunology and Allergy Medicine skin and connective tissue diseases Molecular Biology Receiver operating characteristic business.industry Sodium Area under the curve Immunoglobulins Intravenous Infant Hematology Odds ratio medicine.disease Infliximab Confidence interval Logistic Models 030104 developmental biology Child Preschool 030220 oncology & carcinogenesis Multivariate Analysis Cytokines Biomarker (medicine) Female Kawasaki disease Inflammation Mediators business medicine.drug |
| Zdroj: | Cytokine. 114:26-31 |
| ISSN: | 1043-4666 |
| Popis: | Objective To search the predictive factors of infliximab resistance in intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients. Study design. Twenty-seven patients with KD who received infliximab after 4–5 g/kg of IVIG therapy from 2013 to 2015 were consecutively recruited in this study. They were divided into two groups: patients who responded to infliximab (infliximab-responsive group, n = 15) and patients who required additional therapy for the disease control (infliximab-resistant group, n = 12). We analyzed the clinical and laboratory parameters just before the infliximab treatment including serum levels of procalcitonin and cytokines with respect to the infliximab response. Results Serum procalcitonin concentration (P = 0.017), neutrophils to lymphocytes ratio (P = 0.013), and % neutrophils (P = 0.004) were higher, and serum sodium concentration (P = 0.017) was lower in infliximab-resistant group than those of infliximab-responsive group, respectively. Multivariate logistic regression analyses indicated that higher procalcitonin concentration (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.00–5.00, P = 0.046) and lower sodium levels (OR 0.64, 95% CI 0.32–1.00, P = 0.047), but not other variables, were associated with infliximab-resistance. Serum procalcitonin concentrations positively correlated with the serum levels of interleukin-6, soluble tumor necrosis factor receptor type 1 and type 2, respectively. Analyses of the receiver operating characteristic (ROC) curve showed that the cut-off value of procalcitonin 2.0 ng/ml had 58.3% of sensitivity and 93.3% of specificity. ROC analysis yielded an area under the curve (AUC) of 0.739 to predict infliximab-resistance. Conclusion Serum procalcitonin might be an effective biomarker to predict infliximab resistance in severe KD patients who are refractory to IVIG treatment. |
| Databáze: | OpenAIRE |
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