Biomarkers of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease

Autor: Songling Fu, Yiying Zhang, Fangqi Gong, Wei Wang, Chunhong Xie, Fei-Yue Ma, Wei-Xing Kong
Rok vydání: 2019
Předmět:
Male
China
medicine.medical_specialty
Adolescent
Databases
Factual
Globulin
Drug Resistance
Coronary Artery Disease
Mucocutaneous Lymph Node Syndrome
Coronary Angiography
Elevated serum ferritin
Sensitivity and Specificity
Severity of Illness Index
Gastroenterology
Fibrin Fibrinogen Degradation Products
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
medicine
Humans
030212 general & internal medicine
Stage (cooking)
Child
Retrospective Studies
biology
Interleukin-6
business.industry
Serum ferritin level
Immunoglobulins
Intravenous
Infant
Hospitals
Pediatric
medicine.disease
Logistic Models
medicine.anatomical_structure
ROC Curve
Area Under Curve
Child
Preschool
Immunoglobulin G
Ferritins
Pediatrics
Perinatology and Child Health
biology.protein
Serum Globulins
Kawasaki disease
Tumor necrosis factor alpha
Antibody
business
Biomarkers
Artery
Zdroj: World Journal of Pediatrics. 15:168-175
ISSN: 1867-0687
1708-8569
Popis: Currently, there are no reliable indicators for predicting intravenous immunoglobulin resistance and coronary artery lesions in the early stage of Kawasaki disease. A total of 300 patients with Kawasaki disease were studied retrospectively. Laboratory data were compared between the intravenous immunoglobulin resistant (29 patients) and responsive groups, and between the groups with coronary artery lesions (48 patients) and without coronary artery lesions. The intravenous immunoglobulin resistant group had significantly higher D-dimer, globulin, interleukin-6 and serum ferritin levels in comparison to the intravenous immunoglobulin responder group. D-dimer level had a sensitivity of 87.0% and a specificity of 56.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 1.09 mg/L. Globulin had a sensitivity of 62.1% and a specificity of 82.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 34.7 g/L. Serum ferritin level had a sensitivity of 42.9% and a specificity of 88.8% for predicting intravenous immunoglobulin resistance at a cutoff point of 269.7 ng/mL. The patients with coronary artery lesions had higher D-dimer and tumor necrosis factor-α level. D-dimer level had a sensitivity of 50% and a specificity of 78.6% for predicting coronary artery lesions at a cutoff point of 1.84 mg/L. Based on analysis by multivariate logistic regression, serum ferritin and globulin were independent risks for intravenous immunoglobulin resistance, D-dimer was independent risk for coronary artery lesions. Elevated serum ferritin, globulin and D-dimer levels are significantly associated with intravenous immunoglobulin resistance in Kawasaki disease. Moreover, serum D-dimer is significantly increased in Kawasaki disease with coronary artery lesions.
Databáze: OpenAIRE
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