Influencing factors of gamma globulin insensitivity in children with Kawasaki disease and their relation to levels of ferritin,ALT,AST and erythrocyte deposition rate

Xia Ling; Zhu Fang-gen; Liu Xiao-ling

doi:10.3969/j.issn.1672-8157.2024.06.017

Abstract：Objective To investigate the influence factors of insensitivity to intravenous gammaglobulin (IVIG) treatment in children with Kawasaki disease and their relation to serum levels of serum ferritin,alanine aminotransferase (ALT),aspartate amino-transferase (AST) and erythrocyte deposition rate. Methods The clinical data of 20 children with Kawasaki disease admitted to An-qing First People's Hospital from July 2020 to January 2024 who were insensitive to IVIG and that of other 55 children with Kawasa-ki disease treated in the same hospital and the same period who were sensitive to IVIG were collected retrospectively. The former 20 children were included in the insensitive group and the latter 55 children were included in the sensitive group. The influencing factors of IVIG insensitivity in children with Kawasaki disease were analyzed,and the levels of serum ferritin,ALT,AST and erythrocyte deposition rate were compared between the two groups. Results The long duration of fever (OR=1.605,95％CI:1.033-2.494),cor-onary artery damage (OR=1.855,95％CI:1.024-3.360),high proportion of peripheral neutrophils (OR=1.642,95％CI:1.024-2.634) and low level of peripheral blood platelet (PLT) (CI=1.781,95％CI:1.015-1.196) were independent risk factors for insensitivity to in-travenous gamma globulin therapy in children with Kawasaki disease (P<0.05). The level of serum ferritin and erythrocyte deposition rate ((210.62±34.73) ng·mL-1 and (22.41±4.62) mm·h-1 respectively) in the insensitive group were higher than those in the sensitive group ((177.88±28.74) ng·mL-1 and (16.41±3.55) mm·h-1 respectively) (t=4.123,5.957,both P<0.05),but there was no significant difference in levels of serum ALT and AST between the two groups ((43.97±4.77) U·L-1,(37.89±4.32) U·L-1 vs (44.22±4.61) U·L-1,(38.16±5.15) U·L-1 respectively) (t=4.123,5.957,both P>0.05). Conclusion Independent risk factors for insensitivity to IVIG ther-apy in children with Kawasaki disease include longer duration of fever,coronary artery damage,higher peripheral blood neutrophils ratio,and lower peripheral blood level of PLT. Insensitivity to IVIG therapy in children with Kawasaki disease may affect level of serum ferritin and erythrocyte deposition rate. However,its effect on serum ALT and AST levels is not significant.