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J Pediatr. 2008 Sep;153(3):365-8. doi: 10.1016/j.jpeds.2008.03.014. Epub 2008 May 16.

Risk factors for nonresponse to therapy in Kawasaki disease.

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1
Division of Infectious Disease, Children's Hospital of Orange County, Orange, CA, USA.

Abstract

OBJECTIVE:

To study the refractory cases of Kawasaki disease (KD) and identify potential risk factors in patients in whom standard therapy fails.

STUDY DESIGN:

A retrospective chart review of patients with KD admitted from January 1, 2002, through December 31, 2006. Demographic, clinical, laboratory, echocardiographic, and therapeutic data were recorded.

RESULTS:

Of 196 patients, 40 (20%) needed re-treatment. The number of refractory cases were 7 (14.3%), 6 (17.1%), 11(28.9%), 10 (24.4%), and 6 (17.6%) for 2002 to 2006, respectively. There were no significant differences in age, sex, ethnicity, number of days with symptoms at diagnosis, white blood cell count, erythrocyte sedimentation rate (ESR), or C-reactive protein (CRP). Refractory patients had higher band counts (22.7% vs 7%), lower albumin levels (3 vs 3.4), and a higher number of abnormal echocardiography results at diagnosis (80% vs 16.1%).

CONCLUSIONS:

An elevated band count, low albumin level, and an abnormal initial echocardiography result can be useful tools to identify patients at risk for a more complicated clinical course.

PMID:
18534243
DOI:
10.1016/j.jpeds.2008.03.014
[Indexed for MEDLINE]
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