High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis
Background Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever ≥36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This stu...
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| Veröffentlicht in: | Paediatric drugs 2022-11, Vol.24 (6), p.689-697 |
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| creator | Han, Seung Beom Suh, Woosuck Rhim, Jung-Woo |
| description | Background
Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever ≥36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This study aimed to determine the independent association between increased IVIG resistance and 10% IVIG therapy.
Methods
Medical records of pediatric patients with KD were retrospectively reviewed. Clinical and laboratory characteristics were compared between patients receiving 5% IVIG therapy and those receiving 10% IVIG therapy. Between IVIG-responsive and IVIG-resistant patients, a multivariate analysis was performed to determine the independent factors for IVIG resistance.
Results
A total of 119 patients were included in this study: 81 (68.1%) and 38 (31.9%) patients received 5% and 10% IVIG therapy, respectively. IVIG resistance was identified in 34 (28.6%) patients: 44.7% of patients receiving 10% IVIG therapy and 21.0% of patients receiving 5% IVIG therapy (
p
= 0.008). The clinical manifestations and outcomes were comparable between patients who received 5% IVIG therapy and those who received 10% IVIG therapy. IVIG resistance was significantly associated with fewer fever days at IVIG administration (
p
= 0.032), a higher percentage of neutrophils (
p
= 0.013), and 10% IVIG treatment (
p
= 0.004) in the multivariate analysis.
Conclusion
10% IVIG therapy was significantly associated with increased reporting of IVIG resistance. However, the increase in patients with fever patterns consistent with IVIG resistance seemed to represent adverse febrile reactions resulting from using high-concentration IVIG rather than increased severity of KD. |
| doi_str_mv | 10.1007/s40272-022-00537-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9510556</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A723971024</galeid><sourcerecordid>A723971024</sourcerecordid><originalsourceid>FETCH-LOGICAL-c518t-549317d89bf0d414c105bbc23e29ce56b9a8764fcec6a0dddff1fdfeba62f8323</originalsourceid><addsrcrecordid>eNp9UtuKFDEQbUTBdfUHfAr43GuSvvsgDO2uO7gijCs-hnS60pO1OxmT9Mh8nz9mzfSiLoiEkKJyzqlK5STJS0YvGKXV65BTXvGUcty0yKq0fpScMVY1KaeseXyK87Soq_pp8iyEO0pZlZX8LPl5bYZt2jqrwEYvo3GWrI_RHqybA1lP02zdMLpuHo0lH-UBr_U4AxJI3AJp3ewDEKfJFezBE2l7spHxlNnAzvkIPbn1IOOEFTAVTIjyyEa5dmvG3oMlX03ckg_yhwzymyHvTAAZ4A1Zkc_GDiOkLXJRfAPRu7ADFc0eyMrK8YByz5MnWo4BXtyf58mXq8vb9jq9-fR-3a5uUlWwOqZF3mSs6uum07TPWa4YLbpO8Qx4o6Aou0bWVZlrBaqUtO97rZnuNXSy5LrOeHaevF10d3M3Qb9MbBQ7bybpD8JJIx7eWLMVg9uLpsBSRYkCr-4FvPs-Q4jiDqeHrwgCf69hvKT0L9QgRxDGaodiajJBiVXFs6ZilOeIuvgHClcPk1HOgjaYf0DgC0HhCIMH_btxRsXRRGIxkUATiZOJRI2kbCEFBNsB_J-O_8P6BQO-ztQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2729126006</pqid></control><display><type>article</type><title>High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Han, Seung Beom ; Suh, Woosuck ; Rhim, Jung-Woo</creator><creatorcontrib>Han, Seung Beom ; Suh, Woosuck ; Rhim, Jung-Woo</creatorcontrib><description>Background
Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever ≥36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This study aimed to determine the independent association between increased IVIG resistance and 10% IVIG therapy.
Methods
Medical records of pediatric patients with KD were retrospectively reviewed. Clinical and laboratory characteristics were compared between patients receiving 5% IVIG therapy and those receiving 10% IVIG therapy. Between IVIG-responsive and IVIG-resistant patients, a multivariate analysis was performed to determine the independent factors for IVIG resistance.
Results
A total of 119 patients were included in this study: 81 (68.1%) and 38 (31.9%) patients received 5% and 10% IVIG therapy, respectively. IVIG resistance was identified in 34 (28.6%) patients: 44.7% of patients receiving 10% IVIG therapy and 21.0% of patients receiving 5% IVIG therapy (
p
= 0.008). The clinical manifestations and outcomes were comparable between patients who received 5% IVIG therapy and those who received 10% IVIG therapy. IVIG resistance was significantly associated with fewer fever days at IVIG administration (
p
= 0.032), a higher percentage of neutrophils (
p
= 0.013), and 10% IVIG treatment (
p
= 0.004) in the multivariate analysis.
Conclusion
10% IVIG therapy was significantly associated with increased reporting of IVIG resistance. However, the increase in patients with fever patterns consistent with IVIG resistance seemed to represent adverse febrile reactions resulting from using high-concentration IVIG rather than increased severity of KD.</description><identifier>ISSN: 1174-5878</identifier><identifier>EISSN: 1179-2019</identifier><identifier>DOI: 10.1007/s40272-022-00537-8</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Body temperature ; Care and treatment ; Child health services ; Coronary vessels ; Diagnosis ; Drug resistance ; Fever ; Genetic aspects ; Hospitals ; Immunoglobulins ; Internal Medicine ; Kawasaki disease ; Laboratories ; Medical records ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Neutrophils ; Original ; Original Research Article ; Patients ; Pediatrics ; Pharmacotherapy ; Prevention ; Veins & arteries</subject><ispartof>Paediatric drugs, 2022-11, Vol.24 (6), p.689-697</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>Copyright Springer Nature B.V. Nov 2022</rights><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-549317d89bf0d414c105bbc23e29ce56b9a8764fcec6a0dddff1fdfeba62f8323</citedby><cites>FETCH-LOGICAL-c518t-549317d89bf0d414c105bbc23e29ce56b9a8764fcec6a0dddff1fdfeba62f8323</cites><orcidid>0000-0002-7730-5772 ; 0000-0002-1299-2137 ; 0000-0002-0227-3809</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40272-022-00537-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40272-022-00537-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Han, Seung Beom</creatorcontrib><creatorcontrib>Suh, Woosuck</creatorcontrib><creatorcontrib>Rhim, Jung-Woo</creatorcontrib><title>High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis</title><title>Paediatric drugs</title><addtitle>Pediatr Drugs</addtitle><description>Background
Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever ≥36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This study aimed to determine the independent association between increased IVIG resistance and 10% IVIG therapy.
Methods
Medical records of pediatric patients with KD were retrospectively reviewed. Clinical and laboratory characteristics were compared between patients receiving 5% IVIG therapy and those receiving 10% IVIG therapy. Between IVIG-responsive and IVIG-resistant patients, a multivariate analysis was performed to determine the independent factors for IVIG resistance.
Results
A total of 119 patients were included in this study: 81 (68.1%) and 38 (31.9%) patients received 5% and 10% IVIG therapy, respectively. IVIG resistance was identified in 34 (28.6%) patients: 44.7% of patients receiving 10% IVIG therapy and 21.0% of patients receiving 5% IVIG therapy (
p
= 0.008). The clinical manifestations and outcomes were comparable between patients who received 5% IVIG therapy and those who received 10% IVIG therapy. IVIG resistance was significantly associated with fewer fever days at IVIG administration (
p
= 0.032), a higher percentage of neutrophils (
p
= 0.013), and 10% IVIG treatment (
p
= 0.004) in the multivariate analysis.
Conclusion
10% IVIG therapy was significantly associated with increased reporting of IVIG resistance. However, the increase in patients with fever patterns consistent with IVIG resistance seemed to represent adverse febrile reactions resulting from using high-concentration IVIG rather than increased severity of KD.</description><subject>Body temperature</subject><subject>Care and treatment</subject><subject>Child health services</subject><subject>Coronary vessels</subject><subject>Diagnosis</subject><subject>Drug resistance</subject><subject>Fever</subject><subject>Genetic aspects</subject><subject>Hospitals</subject><subject>Immunoglobulins</subject><subject>Internal Medicine</subject><subject>Kawasaki disease</subject><subject>Laboratories</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Neutrophils</subject><subject>Original</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pharmacotherapy</subject><subject>Prevention</subject><subject>Veins & arteries</subject><issn>1174-5878</issn><issn>1179-2019</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9UtuKFDEQbUTBdfUHfAr43GuSvvsgDO2uO7gijCs-hnS60pO1OxmT9Mh8nz9mzfSiLoiEkKJyzqlK5STJS0YvGKXV65BTXvGUcty0yKq0fpScMVY1KaeseXyK87Soq_pp8iyEO0pZlZX8LPl5bYZt2jqrwEYvo3GWrI_RHqybA1lP02zdMLpuHo0lH-UBr_U4AxJI3AJp3ewDEKfJFezBE2l7spHxlNnAzvkIPbn1IOOEFTAVTIjyyEa5dmvG3oMlX03ckg_yhwzymyHvTAAZ4A1Zkc_GDiOkLXJRfAPRu7ADFc0eyMrK8YByz5MnWo4BXtyf58mXq8vb9jq9-fR-3a5uUlWwOqZF3mSs6uum07TPWa4YLbpO8Qx4o6Aou0bWVZlrBaqUtO97rZnuNXSy5LrOeHaevF10d3M3Qb9MbBQ7bybpD8JJIx7eWLMVg9uLpsBSRYkCr-4FvPs-Q4jiDqeHrwgCf69hvKT0L9QgRxDGaodiajJBiVXFs6ZilOeIuvgHClcPk1HOgjaYf0DgC0HhCIMH_btxRsXRRGIxkUATiZOJRI2kbCEFBNsB_J-O_8P6BQO-ztQ</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Han, Seung Beom</creator><creator>Suh, Woosuck</creator><creator>Rhim, Jung-Woo</creator><general>Springer International Publishing</general><general>Springer</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7730-5772</orcidid><orcidid>https://orcid.org/0000-0002-1299-2137</orcidid><orcidid>https://orcid.org/0000-0002-0227-3809</orcidid></search><sort><creationdate>20221101</creationdate><title>High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis</title><author>Han, Seung Beom ; Suh, Woosuck ; Rhim, Jung-Woo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-549317d89bf0d414c105bbc23e29ce56b9a8764fcec6a0dddff1fdfeba62f8323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Body temperature</topic><topic>Care and treatment</topic><topic>Child health services</topic><topic>Coronary vessels</topic><topic>Diagnosis</topic><topic>Drug resistance</topic><topic>Fever</topic><topic>Genetic aspects</topic><topic>Hospitals</topic><topic>Immunoglobulins</topic><topic>Internal Medicine</topic><topic>Kawasaki disease</topic><topic>Laboratories</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Neutrophils</topic><topic>Original</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pharmacotherapy</topic><topic>Prevention</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Seung Beom</creatorcontrib><creatorcontrib>Suh, Woosuck</creatorcontrib><creatorcontrib>Rhim, Jung-Woo</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Paediatric drugs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Seung Beom</au><au>Suh, Woosuck</au><au>Rhim, Jung-Woo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis</atitle><jtitle>Paediatric drugs</jtitle><stitle>Pediatr Drugs</stitle><date>2022-11-01</date><risdate>2022</risdate><volume>24</volume><issue>6</issue><spage>689</spage><epage>697</epage><pages>689-697</pages><issn>1174-5878</issn><eissn>1179-2019</eissn><abstract>Background
Intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD) is defined as persistent or recrudescent fever ≥36 hours after IVIG infusion. We have experienced an increase in IVIG resistance in patients with KD since the substitution of 10% IVIG for 5% IVIG. This study aimed to determine the independent association between increased IVIG resistance and 10% IVIG therapy.
Methods
Medical records of pediatric patients with KD were retrospectively reviewed. Clinical and laboratory characteristics were compared between patients receiving 5% IVIG therapy and those receiving 10% IVIG therapy. Between IVIG-responsive and IVIG-resistant patients, a multivariate analysis was performed to determine the independent factors for IVIG resistance.
Results
A total of 119 patients were included in this study: 81 (68.1%) and 38 (31.9%) patients received 5% and 10% IVIG therapy, respectively. IVIG resistance was identified in 34 (28.6%) patients: 44.7% of patients receiving 10% IVIG therapy and 21.0% of patients receiving 5% IVIG therapy (
p
= 0.008). The clinical manifestations and outcomes were comparable between patients who received 5% IVIG therapy and those who received 10% IVIG therapy. IVIG resistance was significantly associated with fewer fever days at IVIG administration (
p
= 0.032), a higher percentage of neutrophils (
p
= 0.013), and 10% IVIG treatment (
p
= 0.004) in the multivariate analysis.
Conclusion
10% IVIG therapy was significantly associated with increased reporting of IVIG resistance. However, the increase in patients with fever patterns consistent with IVIG resistance seemed to represent adverse febrile reactions resulting from using high-concentration IVIG rather than increased severity of KD.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s40272-022-00537-8</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7730-5772</orcidid><orcidid>https://orcid.org/0000-0002-1299-2137</orcidid><orcidid>https://orcid.org/0000-0002-0227-3809</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Paediatric drugs, 2022-11, Vol.24 (6), p.689-697 |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Body temperature Care and treatment Child health services Coronary vessels Diagnosis Drug resistance Fever Genetic aspects Hospitals Immunoglobulins Internal Medicine Kawasaki disease Laboratories Medical records Medicine Medicine & Public Health Multivariate analysis Neutrophils Original Original Research Article Patients Pediatrics Pharmacotherapy Prevention Veins & arteries |
| title | High-Concentration Intravenous Immunoglobulin May Influence the Course of Fever and Rate of Reported Treatment Resistance in Children With Kawasaki Disease: A Single-Center Retrospective Analysis |
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