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Pediatric Rheumatology

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Open Access 01-12-2018 | Research article

Coronary artery status of patients with transient fever 24–36 h after first IVIG infusion did not differ from that seen in responsive patients

Authors: Jae Suk Baek, Jeong Jin Yu, Mi Jin Kim, Jihye You, Hyun Ok Jun, Young-Hwue Kim, Jae-Kon Ko

Published in: Pediatric Rheumatology | Issue 1/2018

Abstract

Background

Current management guidelines for patients with Kawasaki disease (KD) differ in their recommendations for fever observation times when determining resistance to initial intravenous immunoglobulin (IVIG). This retrospective study assessed coronary artery status in patients with transient fever 24–36 h after the completion of a first IVIG infusion.

Methods

Children with KD treated with IVIG between January 2006 and February 2017 were included. Subjects were divided into three groups according to response following the completion of initial IVIG treatment (Group 1, no fever after 24 h; Group 2, transient fever at 24–36 h; Group 3, others).

Results

A total of 879 children were evaluated (Group 1, n = 663; Group 2, n = 54; Group 3, n = 162). During the subacute phase, the left main coronary artery (LMCA) diameter z score in both groups was significantly lower than that in Group 3 (Group 1: 1.02, Group 2: 0.87, Group 3: 1.24; Group 1 vs 2, P = 0.298; Group 1 vs 3, P = 0.025; Group 2 vs 3, P = 0.042); similar results were seen with the left anterior descending coronary artery (LAD) diameter z score (Group 1: 0.64, Group 2: 0.38, Group 3: 0.98; Group 1 vs 2, P = 0.083; Group 1 vs 3, P = 0.001; Group 2 vs 3, P = 0.004). The coronary artery (CA) status also did not differ between Groups 1 and 2 during the convalescent phase (z score of LMCA was 0.70 in Group 1 and 0.74 in Group 2, P = 0.790; z score of LAD was 0.42 and 0.46 respectively, P = 0.796; z score of right CA was 0.07 and 0.00 respectively, P = 0.630). A multivariate logistic regression analysis identified total bilirubin level (OR, 2.472; 95% CI, 1.284–4.762; P = 0.007) as the only significant predictor of persisting fever over 36 h in patients with fever 24 h after the completion of initial IVIG.

Conclusions

The CA status of patients with transient fever 24–36 h after the first IVIG infusion did not differ from that seen in responsive patients.

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Title: Coronary artery status of patients with transient fever 24–36 h after first IVIG infusion did not differ from that seen in responsive patients
Authors: Jae Suk Baek
Jeong Jin Yu
Mi Jin Kim
Jihye You
Hyun Ok Jun
Young-Hwue Kim
Jae-Kon Ko
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Pediatric Rheumatology / Issue 1/2018
Electronic ISSN: 1546-0096
DOI: https://doi.org/10.1186/s12969-018-0301-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Coronary artery status of patients with transient fever 24–36 h after first IVIG infusion did not differ from that seen in responsive patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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