Abstract 106: Utility of Ferritin as a Predictor of the Patients with Kawasaki Disease Refractory to Intravenous Immunoglobulin Therapy

Abstract

Purpose: Several scoring systems for prediction of non-responsiveness to initial course of intravenous immunoglobulin (IVIG) therapy have been available in the patients diagnosed as Kawasaki disease (KD). However, all non-responders cannot be identified completely by these scoring systems. The aim of this study is to investigate whether ferritin can be a useful marker as a predictor of the patients with KD refractory to IVIG therapy. Materials and Methods: This retrospective study enrolled 63 patients with KD hospitalized at Kitakyushu General Hospital during 2010 to 2013. These patients were divided into IVIG responders (n= 41) and non-responders (n=22). Serum ferritin levels and the scoring systems for prediction of non-responsiveness to initial IVIG treatment were compared between these two groups. Results: Serum ferritin level was significantly elevated in non-responders (p=0.01). The area under the receiver-operating-characteristics curve was 0.698, and the sensitivity and specificity in more than 215 ng/ml of serum ferritin levels was 54.5% and 85.4%, respectively. Two of the three scoring systems for prediction of non-responsiveness to initial IVIG treatment in non-responders were also significantly higher scores than that in responders, but many non-responders had a low score of these scoring systems. Approximately half of the patients with low score of these scoring systems had high serum ferritin level (≧ 215 ng/ml). Conclusion: Serum ferritin level can be a useful marker for the prediction of non-responsiveness to initial IVIG treatment and may be an important complementary marker to the scoring systems for prediction of non-responsiveness to initial IVIG treatment.