The relationship of eosinophilia to intravenous immunoglobulin treatment failure in Kawasaki disease

Kuo, Ho‐Chang; Yang, Kuender D.; Liang, Chi-Di; Bong, Chin-Nam; Yu, Hong‐Ren; Wang, Lin; Wang, Chih‐Lu

doi:10.1111/j.1399-3038.2007.00516.x

Cited by 121 publications

(137 citation statements)

References 25 publications

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“…20,21 Several factors have been reported to be associated with refractory cases, including younger age, 22 male gender, 23 earlier presentation, 3 initial treatment before day 4 of fever, lower platelets, 3,22 lower hemoglobin, 3,24 higher white blood cell 25 and bands counts, 3 elevated C-reactive protein 3,19,22,24,26,27 and erythrocyte sedimentation rate, 18 elevated lactate dehydrogenase, 19,24 abnormal liver function, 3,19,22,23,26,27 lower serum albumin 23,28,29 and certain biomarkers, 30-33 among others. 3 Thus, failure to reduce inflammation and fever after immunoglobulin therapy are markers for immunoglobulin resistance in Kawasaki disease.…”

Section: Discussionmentioning

confidence: 99%

Immunoglobulin Resistance in Kawasaki Disease

Hartas

Hashmi

Pham-Peyton

et al. 2015

Pediatric Allergy, Immunology, and Pulmonology

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Background: The aim of this study was to identify risk factors for immunoglobulin resistance, including clinical symptoms such as arthritis and the pH of intravenous immunoglobulin. Methods: The data of children with Kawasaki disease who had received immunoglobulin were evaluated. Data regarding the brand of immunoglobulin administered were abstracted from the pharmacy records. Results: Eighty consecutive children with Kawasaki disease were evaluated (Mdn age = 28 months, 66% male). The prevalence of immunoglobulin resistance was 30%. Arthritis was a presenting symptom in the acute phase of Kawasaki disease in 8% (6/80, all male) and was seen in significant association with immunoglobulin resistance in comparison to those without arthritis (16.7% vs. 0.2%, p = 0.008). Next, the immunoglobulin brand types were divided into two groups: the relatively high pH group (n = 16), including Carimune (pH 6.6 -0.2), and the low pH group (n = 63), including Gamunex (pH 4-4.5) or Privigen (pH 4.6-5). Overall, no significant difference in immunoglobulin responsiveness was found between the low pH and the high pH groups (73% vs. 56%, p = 0.193), although the low pH group showed a trend toward a larger decrease in erythrocyte sedimentation rate ( p = 0.048), lower steroid use ( p = 0.054), and lower coronary involvement ( p = 0.08) than those in the high pH group. Conclusions: Children presenting with arthritis in the acute phase of Kawasaki disease may be at risk for immunoglobulin resistance.

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Section: Discussionmentioning

confidence: 99%

Immunoglobulin Resistance in Kawasaki Disease

Hartas

Hashmi

Pham-Peyton

et al. 2015

Pediatric Allergy, Immunology, and Pulmonology

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“…25 IVIG treatment responsiveness was defined as defervescence 48 h after the completion of IVIG treatment and no fever (temperature, 4381C) recurrence for at least 7 days after the initial IVIG treatment, with marked improvement of inflammatory signs. 7,26,27 Patients with IVIG resistance received another dose of IVIG (1-2 g/kg) or other anti-inflammatory regiments.…”

Section: Materials and Methods Patientsmentioning

confidence: 99%

CASP3 gene single-nucleotide polymorphism (rs72689236) and Kawasaki disease in Taiwanese children

Kuo

Juo

et al. 2010

J Hum Genet

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,9,10Kawasaki disease (KD) is characterized by systemic vasculitis of unknown etiology. A study from Japan reported that G to A substitution of a single-nucleotide polymorphism (SNP) located in the 5¢-untranslated region of caspase 3 (CASP3) (rs72689236), which was associated with nuclear factor of activated T cell-mediated T-cell activation, is responsible for susceptibility to KD. This study was conducted to investigate whether the polymorphism of CASP3 is responsible for susceptibility and coronary artery lesion (CAL) formation in KD in the Taiwanese population. A total of 1092 subjects (341 KD patients and 751 controls) were investigated to identify an SNP of rs72689236 using Invader assays (Third Wave Technologies). Our data provided a borderline significant association between the genotypes and allele frequency of rs72689236 in control subjects and KD patients (P¼0.0535 under the dominant model; P¼0.0575 under the allelic model). The A allele of rs72689236 in KD patients and in patients with CAL and intravenous immunoglobulin resistance was seen in a higher frequency. Importantly, a significant association was obtained between rs72689236 and KD patients with aneurysm formation (P¼0.009, under the recessive model). The A allele of rs72689236 is very likely to be a risk allele in the development of aneurysm in patients with KD.

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“…This increase of eosinophils after IVIG treatment is inversely correlated with IVIG treatment failure in KD. (29) Further studies have shown that eosinophil changes after IVIG treatment were positively correlated with changes in interleukin (IL)-5 levels. An increase in eosinophils and IL-5 levels after IVIG treatment is inversely correlated with CAL formation.…”

Section: Introductionmentioning

confidence: 99%