Patterns of Fever in Children After Primary Treatment for Kawasaki Disease
| Autor: | Erika Berry, Beth F. Printz, Octavio Ramilo, John P. Kovalchin, Karen Texter, Jane C. Burns, Preeti Jaggi, Igor Dvorchik, Wei Wang, Adriana H. Tremoulet |
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| Rok vydání: | 2015 |
| Předmět: |
Microbiology (medical)
Pediatrics medicine.medical_specialty Fever Immunoglobulins Coronary Artery Disease Mucocutaneous Lymph Node Syndrome Placebo Article law.invention Paediatrics and Reproductive Medicine Randomized controlled trial law intravenous immunoglobulin hemic and lymphatic diseases Humans Medicine cardiovascular diseases fever Kawasaki disease business.industry Immunoglobulins Intravenous Odds ratio medicine.disease Infliximab Confidence interval Clinical trial Infectious Diseases Pediatrics Perinatology and Child Health Public Health and Health Services Primary treatment Intravenous business medicine.drug |
| Zdroj: | The Pediatric infectious disease journal, vol 34, iss 12 Jaggi, P; Wang, W; Dvorchik, I; Printz, B; Berry, E; Kovalchin, JP; et al.(2015). Patterns of fever in children after primary treatment for Kawasaki disease. Pediatric Infectious Disease Journal, 34(12), 1315-1318. doi: 10.1097/INF.0000000000000891. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/6wv715t7 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000000891 |
| Popis: | Author(s): Jaggi, Preeti; Wang, Wei; Dvorchik, Igor; Printz, Beth; Berry, Erika; Kovalchin, John P; Texter, Karen; Ramilo, Octavio; Burns, Jane C; Tremoulet, Adriana H | Abstract: BackgroundWe sought to determine if fever in the early postintravenous immunoglobulin (IVIG) time period (first 36 hours after IVIG completion) for Kawasaki disease, with or without additional infliximab, can predict IVIG resistance and coronary artery abnormalities (CAA).MethodsAcute Kawasaki disease subjects enrolled in a clinical trial of infliximab plus IVIG (n = 96) versus placebo/IVIG (n = 94) had temperatures recorded every 6 hours after completion of IVIG infusion. Fever was defined as temperature g38.0°C; patients with persistent or recrudescent fever g36 hours after completion of IVIG were classified as IVIG resistant. Multivariable logistic regression by fever pattern was performed to predict outcomes (IVIG resistance and CAA).ResultsThere was no difference in the time to defervescence between the infliximab/IVIG group (n = 96) versus placebo/IVIG group (n = 94). There was no fever after completion of IVIG in the majority of subjects [66% of those with no CAA (n = 139) and 76.5% of those with CAA, (n = 51)]. Although subjects with at least 1 fever 24-36 hours post-IVIG had a higher probability of IVIG resistance [odds ratio = 30.6 (95% confidence interval: 6.7-139.8); P l 0.0001], fever at 24-36 hours was not associated with higher likelihood of CAA. There were also 11% (n = 19) of IVIG responders who had fever at 24-36 hours post-IVIG. The majority of subjects with CAA (43 of 51, 84.3%) were identified by the initial echocardiogram, so the effect of fever on development of CAA could not be assessed.ConclusionsFever in the first 36 hours after IVIG completion is not predictive of CAA. Our data support refraining from retreatment until 36 hours after completion of IVIG. |
| Databáze: | OpenAIRE |
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