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Procalcitonin levels predicting the infliximab response of immunoglobulin resistant Kawasaki disease
- Source :
- Cytokine. 114:26-31
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Objective To search the predictive factors of infliximab resistance in intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients. Study design. Twenty-seven patients with KD who received infliximab after 4–5 g/kg of IVIG therapy from 2013 to 2015 were consecutively recruited in this study. They were divided into two groups: patients who responded to infliximab (infliximab-responsive group, n = 15) and patients who required additional therapy for the disease control (infliximab-resistant group, n = 12). We analyzed the clinical and laboratory parameters just before the infliximab treatment including serum levels of procalcitonin and cytokines with respect to the infliximab response. Results Serum procalcitonin concentration (P = 0.017), neutrophils to lymphocytes ratio (P = 0.013), and % neutrophils (P = 0.004) were higher, and serum sodium concentration (P = 0.017) was lower in infliximab-resistant group than those of infliximab-responsive group, respectively. Multivariate logistic regression analyses indicated that higher procalcitonin concentration (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.00–5.00, P = 0.046) and lower sodium levels (OR 0.64, 95% CI 0.32–1.00, P = 0.047), but not other variables, were associated with infliximab-resistance. Serum procalcitonin concentrations positively correlated with the serum levels of interleukin-6, soluble tumor necrosis factor receptor type 1 and type 2, respectively. Analyses of the receiver operating characteristic (ROC) curve showed that the cut-off value of procalcitonin 2.0 ng/ml had 58.3% of sensitivity and 93.3% of specificity. ROC analysis yielded an area under the curve (AUC) of 0.739 to predict infliximab-resistance. Conclusion Serum procalcitonin might be an effective biomarker to predict infliximab resistance in severe KD patients who are refractory to IVIG treatment.
- Subjects :
- Male
musculoskeletal diseases
0301 basic medicine
medicine.medical_specialty
Immunology
Mucocutaneous Lymph Node Syndrome
Biochemistry
Gastroenterology
Procalcitonin
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Immunology and Allergy
Medicine
skin and connective tissue diseases
Molecular Biology
Receiver operating characteristic
business.industry
Sodium
Area under the curve
Immunoglobulins, Intravenous
Infant
Hematology
Odds ratio
medicine.disease
Infliximab
Confidence interval
Logistic Models
030104 developmental biology
Child, Preschool
030220 oncology & carcinogenesis
Multivariate Analysis
Cytokines
Biomarker (medicine)
Female
Kawasaki disease
Inflammation Mediators
business
medicine.drug
Subjects
Details
- ISSN :
- 10434666
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- Cytokine
- Accession number :
- edsair.doi.dedup.....4c8098592246c6b813bb253dbc1f0405