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Intravenous Immunoglobulin response among patients with incomplete Kawasaki disease: a ten-year review of cases in a tertiary center for children.

Author

Miracle Faith H. Emano,
Jose Jonas D. Del Rosario

Related Institution

Cardiology Section - Philippine Children's Medical Center

Publication Information

Publication Type
Research Project
Date

Abstract

Background: Kawasaki disease is a systemic vasculitis that can lead to coronary artery aneurysm. Patients with incomplete or atypical presentation are most at risk due to late recognition. The standard of treatment is Intravenous Immunoglobulin (IVIg), but approximately 15% of patients develop resistance. There is no local published data on the incidence of incomplete Kawasaki disease and non-response to IVIg.


Objectives: The aim of the study was to determine the demographic profile, clinical findings, and IVIg response among patients with Incomplete Kawasaki Disease during a ten-year period in a tertiary center for children.


Methods: A descriptive study via chart review was done to include patients with incomplete Kawasaki disease from 2008 to 2018. Patient demographic data were recorded, including clinical criteria fulfilled, ancillary laboratory results, echocardiography findings, and treatment response to IVIg.


Results: The incidence of incomplete presentation was 21% among patients with Kawasaki disease. Among these, 61% had coronary artery abnormalities, and 5% were not responsive to IVIg. Patients with incomplete Kawasaki disease were mostly children


Conclusions and Recommendations: The incidence of IVIg resistance among incomplete KD  is low in our study in spite of a high incidence of coronary abnormalities. There are no clinical and laboratory findings associated with IVIg resistance among patients with Incomplete Kawasaki Disease. A follow-up cohort study can be done to determine the natural history of coronary artery disease in patients with incomplete Kawasaki Disease treated with IVIg.

References

1. Empino, C. , Chavez, M. , Del Rosario, J. . Philippine Children's Medical Center"Intravenous immunoglobulin treatment failure in patients with Kawasaki Disease in a tertiary hospital" The PCMC Journal 8(1): 21-27, 2009-2009
2. Aguilera, C , Plucena, L . Philippine Children's Medical Center"Predictors of intravenous immunoglobulin resistance in Kawasaki Disease in a tertiary children’s hospital" The PCMC Journal 13(2): 7-15, 2017-2017

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