A meta-analysis of re-treatment for intravenous immunoglobulin-resistant Kawasaki disease

2015 ◽  
Vol 25 (6) ◽  
pp. 1182-1190 ◽  
Author(s):  
Xi Yang ◽  
Guiying Liu ◽  
Yaqian Huang ◽  
Stella Chen ◽  
Junbao Du ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Coronary Artery ◽  
Body Temperature ◽  
Kawasaki Disease ◽  
Confidence Interval ◽  
Intravenous Immunoglobulin ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Coronary Artery Lesions ◽  
Immunoglobulin Treatment

AbstractObjectiveTo determine the optimal drug therapy for intravenous immunoglobulin-resistant Kawasaki disease.MethodsStudies regarding drug therapy for intravenous immunoglobulin-resistant Kawasaki disease were selected from medical electronic databases including PubMed, Medline, Elsevier, and Springer Link. The effectiveness in terms of temperature recovery and coronary artery damage was compared between a second intravenous immunoglobulin treatment and glucocorticosteroid treatment for children with intravenous immunoglobulin-resistant Kawasaki disease using meta-analysis with Review Manager 5.3 software. Indices to evaluate the effects were body temperature, biomarker levels, and coronary artery lesions detected by echocardiography. Results are reported as relative risks or odds ratio with a 95% confidence interval and p<0.05.ResultsMeta-analysis included 52 patients in the second intravenous immunoglobulin treatment group and 75 patients in the glucocorticosteroid treatment control group from four studies that met our inclusion criteria. Temperatures of patients who received glucocorticosteroid treatment were effectively controlled compared with those who received a second intravenous immunoglobulin treatment (relative risk=0.73, 95% confidence interval: 0.58–0.92, p=0.007). There were no differences, however, in the incidence of coronary artery lesions between the two groups (odds ratio=1.55, 95% confidence interval: 0.57–4.20, p=0.39).ConclusionsGlucocorticosteroids are more effective in controlling body temperature compared with intravenous immunoglobulin re-treatment in intravenous immunoglobulin-resistant Kawasaki disease children; however, glucocorticosteroids and intravenous immunoglobulin re-treatment showed no difference in the prevention of coronary artery lesions.

Predictive value of red blood cell distribution width for coronary artery lesions in patients with Kawasaki disease

2015 ◽  
Vol 26 (6) ◽  
pp. 1151-1157 ◽  
Author(s):  
Haiyan Xu ◽  
Songling Fu ◽  
Wei Wang ◽  
Qing Zhang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Confidence Interval ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Odds Ratio ◽  
Cell Distribution ◽  
Coronary Artery Lesions ◽  
Distribution Width ◽  
Red Blood Cell Distribution

AbstractRecent studies have shown that elevated red blood cell distribution width is associated with poor outcome in cardiovascular diseases. In order to assess the predictive value of red blood cell distribution width, before treatment with intravenous immunoglobulins, for coronary artery lesions in patient with Kawasaki disease, we compared 83 patients with coronary artery lesions and 339 patients without coronary artery lesions before treatment with intravenous immunoglobulin. Clinical, echocardiographic, and biochemical values were evaluated along with red blood cell distribution width. A total of 422 consecutive patients with Kawasaki disease were enrolled into our study. According to receiver operating characteristic curve analysis, the optimal red blood cell distribution width cut-off value for predicting coronary artery lesions was 14.55% (area under the curve was 0.721; p=0.000); eighty-three patients (19.7%) had coronary artery lesions, and 70% of the patients with coronary artery lesions had red blood cell distribution width level >14.55%. Logistic regression analysis revealed that fever duration >14 days (odds ratio was 3.42, 95% confidence interval was 1.27–9.22; p=0.015), intravenous immunoglobulin resistance (odds ratio was 2.33, 95% confidence interval was 1.02–5.29; p=0.04), and red blood cell distribution width >14.55% (odds ratio was 3.49, 95% confidence interval was 2.01–6.05; p=0.000) were independent predictors of coronary artery lesions in patients with Kawasaki disease. In Conclusion, red blood cell distribution width may be helpful for predicting coronary artery lesions in patients with Kawasaki disease.

scholarly journals HMGB1 gene polymorphism is associated with coronary artery lesions and intravenous immunoglobulin resistance in Kawasaki disease

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 770-775 ◽  
Author(s):  
Jong Gyun Ahn ◽  
Yoonsun Bae ◽  
Dongjik Shin ◽  
Jiho Nam ◽  
Kyu Yeun Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Single Nucleotide Polymorphisms ◽  
Odds Ratio ◽  
Ivig Treatment ◽  
Nucleotide Polymorphisms ◽  
Coronary Artery Lesions ◽  
Hmgb1 Level ◽  
Single Nucleotide ◽  
Ivig Resistance

Abstract Objectives Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology that affects infants and young children. Recent reports of elevated serum high mobility group box 1 (HMGB1) level during the acute phase of KD and its relationship to poor response to IVIG treatment suggest a possible association of HMGB1 polymorphisms with KD. We investigated the association between the polymorphisms of the HMGB1 gene, KD susceptibility, coronary artery lesions, and KD response to IVIG treatment. Methods Whole genome sequencing of the HMGB1 gene was performed to identify causative variants. Two tagging single nucleotide polymorphisms of the HMGB1 gene were selected using linkage disequilibrium analysis. The tagging single nucleotide polymorphisms were genotyped using the TaqMan Allelic Discrimination assay in a total of 468 subjects (265 KD patients and 203 controls). Results The HMGB1 single nucleotide polymorphisms were not associated with KD susceptibility. However, in KD patients, there was a significant association of rs1412125 with coronary artery lesions formation in the recessive model (GG vs AA + GA: odds ratio = 4.98, 95% CI = 1.69–14.66, P = 0.005). In addition, rs1412125 was associated with IVIG resistance in the recessive (GG vs AA + GA: odds ratio = 4.11, 95% CI = 1.38–12.23, P = 0.017) and allelic models (G vs A: odds ratio = 1.80, 95% CI = 1.06–3.06, P = 0.027). Conclusion The rs1412125 in HMGB1 might be a risk factor for the development of coronary artery lesions and IVIG resistance in KD patients.

Biomarkers of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease

2019 ◽  
Vol 15 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Wei-Xing Kong ◽  
Fei-Yue Ma ◽  
Song-Ling Fu ◽  
Wei Wang ◽  
Chun-Hong Xie ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Coronary Artery Lesions ◽  
Intravenous Immunoglobulin Resistance

scholarly journals Associations between the angiotensin-converting enzyme insertion/deletion polymorphism and susceptibility to vasculitis: a meta-analysis

2012 ◽  
Vol 13 (1) ◽  
pp. 196-201 ◽  
Author(s):  
Young Ho Lee ◽  
Sung Jae Choi ◽  
Jong Dae Ji ◽  
Gwan Gyu Song
Keyword(s):  
Kawasaki Disease ◽  
Confidence Interval ◽  
Angiotensin Converting Enzyme ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Wegener's Granulomatosis ◽  
The Other ◽  
Converting Enzyme ◽  
Deletion Polymorphism ◽  
Other Hand

Introduction: To explore whether the insertion (I) and deletion (D) polymorphism of angiotensin-converting enzyme ( ACE) confers susceptibility to vasculitis. Materials and methods: A meta-analysis was conducted on the associations between the ACE I/D polymorphism and vasculitis. Results: Twelve studies, including four on Behçet’s disease (BD), four on Henoch–Schenlein purpura (HSP), three on Kawasaki disease (KD), and one on Wegener’s granulomatosis, were available for the meta-analysis. Meta-analysis showed that the DD + ID genotype was associated with susceptibility to vasculitis (odds ratio [OR] 1.468, 95% confidence interval [CI] 1.214–1.468, p = 7.4 × 10−5). The overall OR for the D allele was significantly increased in BD (OR 1.313, 95% CI 1.017–1.695). Meta-analysis of the DD+ID genotype, the DD genotype and the DD vs. II genotype showed marginal associations with BD, but meta-analysis of the D allele, and the DD+ID genotype showed significant associations with HSP (OR 1.446, 95% CI 1.021–2.049, p = 0.038; OR 1.881, 95% CI 1.385–2.595, p = 6.6 × 10−5). On the other hand, meta-analysis showed no association between KD and the ACE I/D polymorphism. Conclusions: This meta-analysis shows that the ACE I/D polymorphism is associated with vasculitis susceptibility, especially in BD and HSP.

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