Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder
Background: A diagnosis of Kawasaki disease (KD) is established using six principal symptoms. Because the principal symptoms are deeply connected with KD, it is thus important to investigate the usefulness of the principal symptoms for evaluating the disease severity of KD. Methods: Patients with...
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| Veröffentlicht in: | Pediatrics international 2012-02, Vol.54 (1), p.14-18 |
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| creator | Nomura, Yuichi Arata, Michiko Masuda, Kiminori Koriyama, Chihaya Suruki, Nobutaka Ueno, Kentaro Yoshikawa, Hideki Eguchi, Taisuke Kawano, Yoshifumi |
| description | Background: A diagnosis of Kawasaki disease (KD) is established using six principal symptoms. Because the principal symptoms are deeply connected with KD, it is thus important to investigate the usefulness of the principal symptoms for evaluating the disease severity of KD.
Methods: Patients with definite KD or suspicion of KD were retrospectively examined. Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non‐responders) were compared between patients with six principal symptoms, including fever of ≤4 days, before treatment of KD (six‐symptom patients), and those with five or fewer symptoms (five‐symptom patients).
Results: The study group of 207 patients who were treated with immunoglobulin consisted of 121 six‐symptom patients and 86 five‐symptom patients. The six‐symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five‐symptom patients. Although the treatments did not differ between the groups, the six‐symptom patients had a higher incidence of non‐responders than the five‐symptom patients (17% vs 5%; P= 0.008). Logistic regression analysis showed that six‐symptom status was related to the risk of being a non‐responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6–17.4). This association was still significant after adjustment for the effect of age, neutrophil proportion, and total bilirubin and sodium (OR, 4.4; 95%CI: 1.4–17.3).
Conclusions: The number of principal symptoms before treatment is a useful guide to KD disease severity. Six‐symptom patients have a higher risk of being a non‐responder than five‐symptom patients. |
| doi_str_mv | 10.1111/j.1442-200X.2011.03512.x |
| format | Article |
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Methods: Patients with definite KD or suspicion of KD were retrospectively examined. Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non‐responders) were compared between patients with six principal symptoms, including fever of ≤4 days, before treatment of KD (six‐symptom patients), and those with five or fewer symptoms (five‐symptom patients).
Results: The study group of 207 patients who were treated with immunoglobulin consisted of 121 six‐symptom patients and 86 five‐symptom patients. The six‐symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five‐symptom patients. Although the treatments did not differ between the groups, the six‐symptom patients had a higher incidence of non‐responders than the five‐symptom patients (17% vs 5%; P= 0.008). Logistic regression analysis showed that six‐symptom status was related to the risk of being a non‐responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6–17.4). This association was still significant after adjustment for the effect of age, neutrophil proportion, and total bilirubin and sodium (OR, 4.4; 95%CI: 1.4–17.3).
Conclusions: The number of principal symptoms before treatment is a useful guide to KD disease severity. Six‐symptom patients have a higher risk of being a non‐responder than five‐symptom patients.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/j.1442-200X.2011.03512.x</identifier><identifier>PMID: 22115193</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Age ; Aspirin - therapeutic use ; Child, Preschool ; Coronary Aneurysm - etiology ; Coronary Aneurysm - prevention & control ; coronary artery abnormality ; Coronary Vessels - pathology ; Disease ; Drug Therapy, Combination ; Humans ; immunoglobulin treatment ; Immunoglobulins - therapeutic use ; Immunoglobulins, Intravenous - therapeutic use ; Infant ; Logistic Models ; Mucocutaneous Lymph Node Syndrome - complications ; Mucocutaneous Lymph Node Syndrome - diagnosis ; Mucocutaneous Lymph Node Syndrome - drug therapy ; Multivariate Analysis ; non-responder ; Patients ; principal symptoms ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Sodium ; Treatment Outcome</subject><ispartof>Pediatrics international, 2012-02, Vol.54 (1), p.14-18</ispartof><rights>2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society</rights><rights>2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5402-c9c2d6adbfeb1d8ab01b39a824908d718488b51afbe3ad60374746e0312fab8d3</citedby><cites>FETCH-LOGICAL-c5402-c9c2d6adbfeb1d8ab01b39a824908d718488b51afbe3ad60374746e0312fab8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1442-200X.2011.03512.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1442-200X.2011.03512.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22115193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nomura, Yuichi</creatorcontrib><creatorcontrib>Arata, Michiko</creatorcontrib><creatorcontrib>Masuda, Kiminori</creatorcontrib><creatorcontrib>Koriyama, Chihaya</creatorcontrib><creatorcontrib>Suruki, Nobutaka</creatorcontrib><creatorcontrib>Ueno, Kentaro</creatorcontrib><creatorcontrib>Yoshikawa, Hideki</creatorcontrib><creatorcontrib>Eguchi, Taisuke</creatorcontrib><creatorcontrib>Kawano, Yoshifumi</creatorcontrib><title>Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background: A diagnosis of Kawasaki disease (KD) is established using six principal symptoms. Because the principal symptoms are deeply connected with KD, it is thus important to investigate the usefulness of the principal symptoms for evaluating the disease severity of KD.
Methods: Patients with definite KD or suspicion of KD were retrospectively examined. Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non‐responders) were compared between patients with six principal symptoms, including fever of ≤4 days, before treatment of KD (six‐symptom patients), and those with five or fewer symptoms (five‐symptom patients).
Results: The study group of 207 patients who were treated with immunoglobulin consisted of 121 six‐symptom patients and 86 five‐symptom patients. The six‐symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five‐symptom patients. Although the treatments did not differ between the groups, the six‐symptom patients had a higher incidence of non‐responders than the five‐symptom patients (17% vs 5%; P= 0.008). Logistic regression analysis showed that six‐symptom status was related to the risk of being a non‐responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6–17.4). This association was still significant after adjustment for the effect of age, neutrophil proportion, and total bilirubin and sodium (OR, 4.4; 95%CI: 1.4–17.3).
Conclusions: The number of principal symptoms before treatment is a useful guide to KD disease severity. Six‐symptom patients have a higher risk of being a non‐responder than five‐symptom patients.</description><subject>Age</subject><subject>Aspirin - therapeutic use</subject><subject>Child, Preschool</subject><subject>Coronary Aneurysm - etiology</subject><subject>Coronary Aneurysm - prevention & control</subject><subject>coronary artery abnormality</subject><subject>Coronary Vessels - pathology</subject><subject>Disease</subject><subject>Drug Therapy, Combination</subject><subject>Humans</subject><subject>immunoglobulin treatment</subject><subject>Immunoglobulins - therapeutic use</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Infant</subject><subject>Logistic Models</subject><subject>Mucocutaneous Lymph Node Syndrome - complications</subject><subject>Mucocutaneous Lymph Node Syndrome - diagnosis</subject><subject>Mucocutaneous Lymph Node Syndrome - drug therapy</subject><subject>Multivariate Analysis</subject><subject>non-responder</subject><subject>Patients</subject><subject>principal symptoms</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sodium</subject><subject>Treatment Outcome</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1vEzEQhi1ERUvhLyCLC1x28deuvQcOENoUNQIOoCIulr072zjZL-wNSf59vU2bAwfEXGZkP-8rzbwIYUpSGuvdKqVCsIQR8jNlhNKU8IyydPcEnR0_nsaZM5UokstT9DyEFSFESSWeoVPGKM1owc-QvjZbE8za4coFMAHwYEYH3Rjw1o1LHNwOD951pRtMg8O-Hca-DXhp_gA2eOlul9i7sMZ9jS247jY-dn2XeAhD31XgX6CT2jQBXj70c_Tj8uL77CpZfJ1_nn1YJGUmCEvKomRVbipbg6WVMpZQywujmCiIqiRVQimbUVNb4KbKCZdCihwIp6w2VlX8HL05-A6-_72BMOrWhRKaxnTQb4IuWNxZKsoi-fafJCVMxXMKmUX09V_oqt_4Lu4R_WhOlJAqQuoAlb4PwUOt471a4_fRSU9p6ZWeQtFTKHpKS9-npXdR-urBf2NbqI7Cx3gi8P4AbF0D-_821t8uPk1T1CcHvQsj7I5649c6l1xm-ubLXC_m4tfNx9mlnvM7St6x9w</recordid><startdate>201202</startdate><enddate>201202</enddate><creator>Nomura, Yuichi</creator><creator>Arata, Michiko</creator><creator>Masuda, Kiminori</creator><creator>Koriyama, Chihaya</creator><creator>Suruki, Nobutaka</creator><creator>Ueno, Kentaro</creator><creator>Yoshikawa, Hideki</creator><creator>Eguchi, Taisuke</creator><creator>Kawano, Yoshifumi</creator><general>Blackwell Publishing Asia</general><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>201202</creationdate><title>Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder</title><author>Nomura, Yuichi ; Arata, Michiko ; Masuda, Kiminori ; Koriyama, Chihaya ; Suruki, Nobutaka ; Ueno, Kentaro ; Yoshikawa, Hideki ; Eguchi, Taisuke ; Kawano, Yoshifumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5402-c9c2d6adbfeb1d8ab01b39a824908d718488b51afbe3ad60374746e0312fab8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Aspirin - therapeutic use</topic><topic>Child, Preschool</topic><topic>Coronary Aneurysm - etiology</topic><topic>Coronary Aneurysm - prevention & control</topic><topic>coronary artery abnormality</topic><topic>Coronary Vessels - pathology</topic><topic>Disease</topic><topic>Drug Therapy, Combination</topic><topic>Humans</topic><topic>immunoglobulin treatment</topic><topic>Immunoglobulins - therapeutic use</topic><topic>Immunoglobulins, Intravenous - therapeutic use</topic><topic>Infant</topic><topic>Logistic Models</topic><topic>Mucocutaneous Lymph Node Syndrome - complications</topic><topic>Mucocutaneous Lymph Node Syndrome - diagnosis</topic><topic>Mucocutaneous Lymph Node Syndrome - drug therapy</topic><topic>Multivariate Analysis</topic><topic>non-responder</topic><topic>Patients</topic><topic>principal symptoms</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sodium</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nomura, Yuichi</creatorcontrib><creatorcontrib>Arata, Michiko</creatorcontrib><creatorcontrib>Masuda, Kiminori</creatorcontrib><creatorcontrib>Koriyama, Chihaya</creatorcontrib><creatorcontrib>Suruki, Nobutaka</creatorcontrib><creatorcontrib>Ueno, Kentaro</creatorcontrib><creatorcontrib>Yoshikawa, Hideki</creatorcontrib><creatorcontrib>Eguchi, Taisuke</creatorcontrib><creatorcontrib>Kawano, Yoshifumi</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nomura, Yuichi</au><au>Arata, Michiko</au><au>Masuda, Kiminori</au><au>Koriyama, Chihaya</au><au>Suruki, Nobutaka</au><au>Ueno, Kentaro</au><au>Yoshikawa, Hideki</au><au>Eguchi, Taisuke</au><au>Kawano, Yoshifumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2012-02</date><risdate>2012</risdate><volume>54</volume><issue>1</issue><spage>14</spage><epage>18</epage><pages>14-18</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background: A diagnosis of Kawasaki disease (KD) is established using six principal symptoms. Because the principal symptoms are deeply connected with KD, it is thus important to investigate the usefulness of the principal symptoms for evaluating the disease severity of KD.
Methods: Patients with definite KD or suspicion of KD were retrospectively examined. Blood test data and the incidence of patients who failed to respond to the initial i.v. immunoglobulin treatment (non‐responders) were compared between patients with six principal symptoms, including fever of ≤4 days, before treatment of KD (six‐symptom patients), and those with five or fewer symptoms (five‐symptom patients).
Results: The study group of 207 patients who were treated with immunoglobulin consisted of 121 six‐symptom patients and 86 five‐symptom patients. The six‐symptom patients were older and had higher neutrophil proportion and total bilirubin, and lower serum sodium at diagnosis than the five‐symptom patients. Although the treatments did not differ between the groups, the six‐symptom patients had a higher incidence of non‐responders than the five‐symptom patients (17% vs 5%; P= 0.008). Logistic regression analysis showed that six‐symptom status was related to the risk of being a non‐responder (odds ratio [OR], 5.3; 95% confidence interval [95%CI]: 1.6–17.4). This association was still significant after adjustment for the effect of age, neutrophil proportion, and total bilirubin and sodium (OR, 4.4; 95%CI: 1.4–17.3).
Conclusions: The number of principal symptoms before treatment is a useful guide to KD disease severity. Six‐symptom patients have a higher risk of being a non‐responder than five‐symptom patients.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>22115193</pmid><doi>10.1111/j.1442-200X.2011.03512.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Age Aspirin - therapeutic use Child, Preschool Coronary Aneurysm - etiology Coronary Aneurysm - prevention & control coronary artery abnormality Coronary Vessels - pathology Disease Drug Therapy, Combination Humans immunoglobulin treatment Immunoglobulins - therapeutic use Immunoglobulins, Intravenous - therapeutic use Infant Logistic Models Mucocutaneous Lymph Node Syndrome - complications Mucocutaneous Lymph Node Syndrome - diagnosis Mucocutaneous Lymph Node Syndrome - drug therapy Multivariate Analysis non-responder Patients principal symptoms Retrospective Studies Risk Factors Severity of Illness Index Sodium Treatment Outcome |
| title | Kawasaki disease patients with six principal symptoms have a high risk of being a non-responder |
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