Prediction Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Meta-analysis

Kuniyoshi, Yasutaka; Tsujimoto, Yasushi; Banno, Masahiro; Taito, Shunsuke; Ariie, Takashi; Takahashi, Natsuki; Tokutake, Haruka; Takada, Toshihiko

doi:10.1542/peds.2022-059175

Cited by 13 publications

(2 citation statements)

References 63 publications

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“…The combined diagnosis of these two markers may enhance the diagnostic accuracy for KD with IVIG resistance, which is consistent with another study (16). Additionally, some studies have indicated that new predictive models have good performance in the diagnosis of IVIG-resistant KD (22,37). The search for new potential markers that could be used in KD diagnostic models to enhance early diagnostic efficiency is ongoing.…”

Section: Discussionsupporting

confidence: 77%

Values of prognostic nutritional index for predicting Kawasaki disease: a systematic review and meta-analysis

Zhong,

Xie,

Wang

et al. 2024

Front. Nutr.

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ObjectiveThis systematic review and meta-analysis aimed to evaluate the relationship between the prognostic nutritional index (PNI) and intravenous immunoglobulin (IVIG) resistance and coronary artery lesion (CAL) in Kawasaki disease (KD).MethodsThe relevant literature was searched on PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar up to August 5, 2023. A pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC) were calculated to assess the predicted values of PNI in KD patients with IVIG resistance and CAL.ResultsA total of 8 articles containing 10 studies involving 7,047 participants were included. The pooled results revealed a pooled sensitivity of 0.44 (0.25–0.65), a pooled specificity of 0.87 (0.73–0.94), a pooled PLR of 3.4 (2.0–5.9), a pooled NLR of 0.65 (0.48–0.87), a pooled DOR of 5.26 (2.76–10.02), and a pooled AUC of 0.75 (0.71–0.78) in the diagnosis of KD with CAL. The pooled results suggested that a pooled sensitivity was 0.69 (0.60–0.77), specificity was 0.76 (0.69–0.82), PLR was 2.9 (2.1–4.1), NLR was 0.40 (0.29–0.56), DOR was 7.27 (3.89–13.59), and AUC was 0.79 (0.75–0.82) in the diagnosis of KD with IVIG resistance. The combined results revealed the pooled sensitivity was 0.63 (0.58–0.67), specificity was 0.82 (0.80–0.83), PLR was 3.09 (1.06–8.98), NLR was 0.38 (0.07–2.02), DOR was 8.23 (0.81–83.16) in differentiating KD from febrile patients. These findings demonstrated low sensitivity and relatively high specificity of PNI for KD, KD-CAL, and IVIG-resistant KD.ConclusionIn conclusion, this study was the first systematic review and meta-analysis of the diagnostic value of PNI in KD with IVIG resistance and CAL. The results suggested that PNI could be used as biomarkers for distinguish KD, KD with CAL, and KD with IVIG resistance.

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Section: Discussionsupporting

confidence: 77%

Values of prognostic nutritional index for predicting Kawasaki disease: a systematic review and meta-analysis

Zhong,

Xie,

Wang

et al. 2024

Front. Nutr.

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“… 59 However, a meta‐analysis of 161 prediction models from 48 studies found that the validity of the existing prediction models for external validation was not clear, and it was still necessary to further develop and validate a reliable IVIG resistance prediction model. 60 …”

Section: Discussionmentioning

confidence: 99%

Knowledge framework of intravenous immunoglobulin resistance in the field of Kawasaki disease: A bibliometric analysis (1997−2023)

Zhang,

Huang,

et al. 2024

Immunity Inflam & Disease

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BackgroundKawasaki disease (KD) is an autoimmune disease with cardiovascular disease as its main complication, mainly affecting children under 5 years old. KD treatment has made tremendous progress in recent years, but intravenous immunoglobulin (IVIG) resistance remains a major dilemma. Bibliometric analysis had not been used previously to summarize and analyze publications related to IVIG resistance in KD. This study aimed to provide an overview of the knowledge framework and research hotspots in this field through bibliometrics, and provide references for future basic and clinical research.MethodsThrough bibliometric analysis of relevant literature published on the Web of Science Core Collection (WoSCC) database between 1997 and 2023, we investigated the cooccurrence and collaboration relationships among countries, institutions, journals, and authors and summarized key research topics and hotspots.ResultsFollowing screening, a total of 364 publications were downloaded, comprising 328 articles and 36 reviews. The number of articles on IVIG resistance increased year on year and the top three most productive countries were China, Japan, and the United States. Frontiers in Pediatrics had the most published articles, and the Journal of Pediatrics had the most citations. IVIG resistance had been studied by 1889 authors, of whom Kuo Ho Chang had published the most papers.ConclusionResearch in the field was focused on risk factors, therapy (atorvastatin, tumor necrosis factor‐alpha inhibitors), pathogenesis (gene expression), and similar diseases (multisystem inflammatory syndrome in children, MIS‐C). “Treatment,” “risk factor,” and “prediction” were important keywords, providing a valuable reference for scholars studying this field. We suggest that, in the future, more active international collaborations are carried out to study the pathogenesis of IVIG insensitivity, using high‐throughput sequencing technology. We also recommend that machine learning techniques are applied to explore the predictive variables of IVIG resistance.

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Comparison of Risk-Scoring Systems in Predicting Kawasaki Disease Associated Coronary Artery Dilation in a North American Cohort

Schwartzenburg,

Strelow,

Chowdhury

2024

Pediatr Cardiol

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Scoring systems used to predict morbidity in children with Kawasaki disease (KD) have been developed and validated in Asian populations. The objective of this study was to assess their utility in predicting the development of coronary artery dilation in children with KD in North America. This was a secondary analysis of a National Institutes of Health / National Heart, Lung, and Blood Institute (NIH/NHLBI) Pediatric Heart Network public use dataset from a multicenter, randomized controlled trial of pulse steroid therapy in KD in a North American cohort. The primary outcome of interest was development of coronary artery dilation. The Harada, Kobayashi, Egami, and Sano scoring systems, originally developed to predict risk of intravenous immunoglobulin (IVIG) resistance in Kawasaki patients in Japan, were applied to this cohort. Subjects were kept in the analysis only if there were complete data for every element of each scoring system—Harada (n = 132), Kobayashi (n = 88), Egami (n = 139), and Sano (n = 82). Patients classified as high-risk by the Harada score were more likely to have significant coronary artery dilation (p = 0.042), were more likely to require IVIG retreatment (p = 0.002), and were more likely to require hospital readmission (p < 0.001). The Egami, Kobayashi, and Sano scores were not predictive for any measured outcome. The Harada score can be useful in identifying KD patients at risk for developing coronary artery dilation and IVIG resistance. The Harada score has demonstrated higher sensitivity but lower specificity, making it a valuable screening tool that may benefit from supplementary diagnostic methods.

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Prediction Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Meta-analysis

Cited by 13 publications

References 63 publications

Values of prognostic nutritional index for predicting Kawasaki disease: a systematic review and meta-analysis

Values of prognostic nutritional index for predicting Kawasaki disease: a systematic review and meta-analysis

Knowledge framework of intravenous immunoglobulin resistance in the field of Kawasaki disease: A bibliometric analysis (1997−2023)

Comparison of Risk-Scoring Systems in Predicting Kawasaki Disease Associated Coronary Artery Dilation in a North American Cohort

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