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Model of Sano et al for Predicting Non-Responsiveness to Intravenous Immunoglobulin (IVIG) Therapy in a Patient with Kawasaki Disease

Description

Sano et al developed a model for identifying a patient with Kawasaki Disease who is likely to be unresponsive to intravenous immunoglobulin (IVIG) therapy. A patient unresponsive to IVIG may benefit from more aggressive management. The authors are from multiple hospitals in Japan.


Patient selection: Kawasaki Disease

 

Criteria for non-response:

(1) therapy with IVIG 1 gram/kg body weight on 2 consecutive days (total 2 g/kg)

(2) persistent fever (>= 37.5°C) for more than 24 hours after second dose (responder afebrile by 24 hours)

 

Parameters:

(1) serum total bilirubin in mg/dL

(2) serum CRP in mg/dL

(3) serum AST activity >= 200 IU/L

 

Parameter

Finding

Points

serum total bilirubin

< 0.9 mg/dL

0

 

>= 0.9 mg/dL

1

serum CRP

< 7.0 mg/dL

0

 

>= 7.0 mg/dL

1

serum AST

< 200 IU/L

0

 

>= 200 IU/L

1

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• A score >= 2 was associated with non-responsiveness to IVIG.


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