Faculty Collaboration Database

Role of the Egami Score in Predicting Intravenous Immunoglobulin Resistance in Kawasaki Disease Among Different Ethnicities. Am J Ther 2016;23(6):e1293-e1299

Date

01/23/2015

Pubmed ID

25611359

DOI

10.1097/MJT.0000000000000045

Scopus ID

2-s2.0-84921827999 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

Early treatment with intravenous immunoglobulin (IVIG) is necessary to help reduce the risk of coronary artery abnormalities, such as coronary artery aneurysms and to help alleviate symptoms, in Kawasaki disease. Some patients, however, do not respond to an initial dose of IVIG and require additional doses. Prediction of these IVIG nonresponders may be of assistance in altering initial therapy to make it more effective. The Egami score has been validated in the Japanese population to predict IVIG nonresponders but has shown to be ineffective in US populations. This study evaluates the Egami score in a Midwest US population, subdividing patients by race and the diagnosis of typical or atypical type of Kawasaki disease. Patients were included in the study if they met criteria for Kawasaki disease and received IVIG in the inpatient setting. A total of 182 patients were studied, and in all studied groups, the Egami score had poor sensitivity at predicting IVIG nonresponders. Sensitivity of the score differed between races and differed between typical and atypical Kawasaki disease. The Egami score, as well as other systems, have been validated to predict IVIG nonresponders. These, however, lack sensitivity in the US population. Other scores developed in the United States have also lacked sensitivity, likely due to the absence of race or Kawasaki disease classification as variables. The development of a sensitive scoring system to predict IVIG nonresponders in US populations will require the incorporation of race and Kawasaki disease classification, factors that seem to alter IVIG response.

Author List

Loomba RS, Raskin A, Gudausky TM, Kirkpatrick E

Authors

Todd M. Gudausky MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Edward C. Kirkpatrick DO Professor in the Pediatrics department at Medical College of Wisconsin
Alexander Raskin MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Drug Resistance
Female
Humans
Immunoglobulins, Intravenous
Immunologic Factors
Infant
Male
Mucocutaneous Lymph Node Syndrome
Retrospective Studies
Sensitivity and Specificity
Treatment Outcome
United States