C-reactive protein level in children with Kawasaki disease unresponsive to initial intravenous immunoglobulin therapy

Abstract

Objective To analyze the serum C reactive protein (CRP) level in children with Kawasaki disease (KD) during the treatment with intravenous immunoglobulin (IVIG).Methods The study objects were collected from January 2009 to December 2012 in the two women and children hospitals.All the patients received IVIG of 2 g/kg daily.The children afebrile in 48 hours after initial administration of IVIG were defined as group A.The febrile children were given second IVIG.Patients who were afebrile in 48 hours after second IVIG were defined as group B.The rest was assigned to group C.CRP levels were detected before initial IVIG and 48 hours after initial IVIG in all the children.Then the data were analyzed statistically.Results 146 children were enrolled and 84 were male and 62 were female.Group A had 110 children with 8 developing CALs (7.3％),group B had 26 children with 5 CALs (19.2％),group C had 10 with 7 CALs (70％).There was significant difference in CRP level 48 hours after initial IVIG between the CALs and the negative children but no difference before initial IVIG.There were no significant differences in both CRP level and CALs between each group pairs before initial IVIG.48 hours after administration of initial IVIG,there were significant differences in both CRP level and CALs among groups A,B,and C.It showed that there was correlation between CRP level and the development of CALs.Conclusions Patients unresponsive to IVIG are liable to develop CALs.Patients with high CRP level 48 hours after initial IVIG are liable to develop to CALs as well.The patients who are the non-responder with high CRP are likely to fail in the additional IVIG treatment.These patients may need other powerful anti-inflammation therapy earlier. Key words: Kawasaki disease; C reactive protein; Intravenous immunoglobulin; Children