A Comprehensive Overview of Risk Scoring Systems for Predicting Intravenous Immunoglobulin (IVIG)- Resistance in Kawasaki Disease Volume 2 - Issue 4

Seiichiro Takeshita¹*, Takashi Kanai², Yoichi Kawamura^2,3 and Shigeaki Nonoyama²

• ¹Division of Nursing, National Defense Medical College, Japan
• ²Department of Pediatrics, National Defense Medical College, Japan
• ³Department of Pediatrics, Japan Self-Defense Forces Central Hospital, Japan

Received: October 24, 2019;   Published: November 12, 2019

Corresponding author: Seiichiro Takeshita, Division of Nursing, National Defense Medical College, Japan

DOI: 10.32474/ACR.2019.02.000142

 

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Abstract

It is important to predict Kawasaki Disease (KD) patients who will be resistant to Intravenous Immunoglobulin (IVIG) before starting the initial treatment, as these patients may have severe inflammation and vasculitis, which will likely lead to the development of Coronary Artery Lesions (CALs). An intensive initial treatment combined with IVIG and additional anti-inflammatory drugs is reported to reduce the occurrence of IVIG resistance and CALs. Although risk scoring systems using usual laboratory data to predict IVIG-resistant patients have mainly been developed in Japan, these systems did not accurately predict non-responders to IVIG among patients in the other countries. In this review, we provide a comprehensive overview of the main risk scoring systems and evaluate the relevant literature.

Abstract| Introduction| Risk scoring systems for predicting IVIG resistance in KD| Definition of IVIG Resistance| The Application of Risk Scoring Systems to KD Patients in Different Nations| Problems and Limits of Risk Scoring Systems for IVIG Resistance in KD| References|