가와사끼병에서 정맥용 면역글로불린 불응군의 특성 (Characteristics of Kawasaki Disease Patients who are Unresponsive to High-dose Intravenous Immunoglobulin Therapy)

서지정보

· 발행기관 : 대한소아감염학회
· 수록지 정보 : Pediatric Infection and Vaccine / 15권 / 2호 / 180 ~ 187페이지
· 저자명 : 국동혁, 고용민, 이근영, 김동언, 이경일, 이준성

초록

Purpose : We wanted to determine the characteristics of patients with Kawasaki disease
(KD) who were unresponsive to intravenous immunoglobulin (IVIG).
Methods : The patients with KD were divided into two groups: the IVIG responsive group
(25 cases) and the IVIG unresponsive group (14 cases). We analyzed various parameters
before and after the administration of IVIG, including the complete blood cell count with
the differential count (%), the erythrocyte segmentation rate (ESR), the C-reactive protein
(CRP) level and the protein and lipid profiles.
Results : The IVIG unresponsive group had a prolonged duration of fever and a higher
incidence of CAL compared to the IVIG responsive group (P<0.001, respectively). Before
IVIG infusion, the neutrophil differential, the ESR and the CRP values were higher (P<
0.001), and the total protein and albumin values were lower in the IVIG unresponsive group
(P=0.01) compared to the IVIG responsive group. After IVIG infusion, there were no significant
changes in the WBC count and CRP levels in the IVIG unresponsive group. The
reduction of the HDL-cholesterol levels by IVIG was more significant in the unresponsive
group (P=0.02).
Conclusion : A more severe and prolonged inflammatory response occurred in the IVIG
unresponsive group at an early stage, and this finding can be detected by such inflammatory
parameters as the neutrophil count and the CRP and HDL-cholesterol levels after IVIG
infusion. (Korean J Pediatr Infect Dis 2008;15:180-187)

영어초록

Purpose : We wanted to determine the characteristics of patients with Kawasaki disease
(KD) who were unresponsive to intravenous immunoglobulin (IVIG).
Methods : The patients with KD were divided into two groups: the IVIG responsive group
(25 cases) and the IVIG unresponsive group (14 cases). We analyzed various parameters
before and after the administration of IVIG, including the complete blood cell count with
the differential count (%), the erythrocyte segmentation rate (ESR), the C-reactive protein
(CRP) level and the protein and lipid profiles.
Results : The IVIG unresponsive group had a prolonged duration of fever and a higher
incidence of CAL compared to the IVIG responsive group (P<0.001, respectively). Before
IVIG infusion, the neutrophil differential, the ESR and the CRP values were higher (P<
0.001), and the total protein and albumin values were lower in the IVIG unresponsive group
(P=0.01) compared to the IVIG responsive group. After IVIG infusion, there were no significant
changes in the WBC count and CRP levels in the IVIG unresponsive group. The
reduction of the HDL-cholesterol levels by IVIG was more significant in the unresponsive
group (P=0.02).
Conclusion : A more severe and prolonged inflammatory response occurred in the IVIG
unresponsive group at an early stage, and this finding can be detected by such inflammatory
parameters as the neutrophil count and the CRP and HDL-cholesterol levels after IVIG
infusion. (Korean J Pediatr Infect Dis 2008;15:180-187)

참고자료

· 없음