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The Clinical and Laboratory Features of Kawasaki Disease with Nonresponsibility to the Acute Antiinflammatory Treatment

Journal of the Korean Pediatric Society 2003;46(5):500-504.
Published online May 15, 2003.
The Clinical and Laboratory Features of Kawasaki Disease with Nonresponsibility to the Acute Antiinflammatory Treatment
Eun-Jung Kim, Myung-Eun Hong, Chang-Woo Lee, Yeon-Geun Oh, Jong-Duk Kim, Hyang-Suk Yoon
Department of Pediatrics, School of Medicine, Wonkwang University, Iksan, Korea
급성기 항염치료에 반응하지 않은 가와사끼병의 임상양상과 검사소견
김은정, 홍명은, 이창우, 오연균, 김종덕, 윤향석
원광대학교 의과대학 소아과학교실
Correspondence: 
Hyang-Suk Yoon, Email: yhs0520@wonkwang.ac.kr
Abstract
Purpose
: To assess the clinical features and laboratory findings in Kawasaki patients with nonresponsibility to the acute antiinflammatory treatment, and identify the risk factors for the nonresponsibility, we reviewed the medical records of patients with Kawasaki disease.
Methods
: A retrospective study of 177 patients with Kawasaki disease at Wonkwang University Medical Center from June, 1997 to June, 2002, was performed. High dose intravenous immune globulin(IVIG) and aspirin were all used for the initial acute antiinflammatory treatment. Two groups, group A(n=19) of initial nonresponders and group B(n=158) of initial responders were compared clinically and laboratorically.
Results
: Nineteen(10.7%) of 177 patients hardly responded to the initial antiinflammatory treatment. Patients with failure to respond to initial treatment(group A) did not differ from the control group in terms of age, sex, WBC count, coronary abnormalities, and evidence of pyuria. Compared with initial responders(group B), the patients who were retreated(group A) had a significantly shorter fever- admission interval(P=0.041), and a higher level of both AST/ALT(P=0.011) and ASO titier(P=0.000).
Conclusion
: Among Kawasaki disease patients studied, retreatment group with initial nonresponders had significantly shorter fever-admission interval, and higher both AST/ALT level and ASO titer, than the initial response group.
Key Words: Kawasaki disease, Retreatment, AST/ALT, ASO


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