ArticleBlood advances2020
Treatment-associated hemolysis in Kawasaki disease: association with blood-group antibody titers in IVIG products.
Article in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Incidence and risk factors for intravenous immunoglobulin-related hemolysis: A systematic review of clinical trial and real-world populations.Transfusion · 2022Pooled it
- 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease.Arthritis & rheumatology (Hoboken, N.J.) · 2022Guideline
- 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Kawasaki Disease.Arthritis care & research · 2022Guideline
- MicroRNAs in Kawasaki disease: An update on diagnosis, therapy and monitoring.Frontiers in immunology · 2022Pooled it
- Randomized trial of different initial intravenous immunoglobulin regimens in Kawasaki disease.Pediatrics international : official journal of the Japan Pediatric Society · 2021Trial
- Multidisciplinary management of refractory Kawasaki disease with bilateral giant coronary artery aneurysms and latent tuberculosis infection: a case report focusing on immune-coagulation-infection crosstalk.Frontiers in immunology · 2026Article
- Case Report: Definite DRESS following phenobarbital exposure with secondary HLH and DAT-positive hemolysis during high-dose IVIG treatment in a child.Frontiers in immunology · 2026Article
- Differences in outcomes associated with ABO blood groups in recipients of IVIG.Blood vessels, thrombosis & hemostasis · 2025Article
- Characteristics of adverse events and clinical risks of intravenous immunoglobulin: a pharmacovigilance study based on FDA Adverse Event Reporting System (FAERS).Frontiers in medicine · 2025Article
- Susceptibility ofHeliyon · 2024Article
- Hemolytic anemia associated with intravenous immunoglobulin in Kawasaki disease.BMC pediatrics · 2024Article
- Editorial: Multisystem inflammatory syndrome in children.Frontiers in pediatrics · 2024Article
- [Evidence-based guidelines for the diagnosis and treatment of Kawasaki disease in children in China (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Article
- Hemolytic anemia following intravenous immunoglobulins in children with PIMS-TS: Two case reports.Frontiers in pediatrics · 2023Article
- Association betweenFrontiers in cardiovascular medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemolytic anemia resulting from IV Immunoglobulin (IVIG) treatment can be a serious complication, especially for those with underlying conditions with a high level of inflammation and after administration of high IVIG dosages, such as Kawasaki disease (KD), a multisystem vasculitis affecting young children. This hemolysis is caused by antibodies against blood groups A and B, but the precise mechanism for hemolysis is not known. We performed a single center, partly retrospective, partly prospective study of a cohort of 581 patients who received IVIG for treatment of KD from 2006 to 2013. Factors associated with hemolysis were identified through univariable and multivariable logistic regression. Six IVIG preparations were assayed for their hemolytic effect with serological and cellular assays to clarify the mechanism of red cell destruction. During the study period, a sudden increase in the incidence of hemolysis was observed, which coincided with the introduction of new IVIG preparations in North America that contained relatively high titers of anti-A and anti-B. These blood-group-specific antibodies were of the immunoglobulin G2 (IgG2) subclass and resulted in phagocytosis by monocyte-derived macrophages in an FcγRIIa-dependent manner. Phagocytosis was increased in the presence of proinflammatory mediators that mimicked the inflammatory state of KD. An increased frequency of severe hemolysis following IVIG administration was caused by ABO blood-group-specific IgG2 antibodies leading to FcγRIIa-dependent clearance of erythrocytes. This increase in adverse events necessitates a reconsideration of the criteria for maximum titer (1:64) of anti-A and anti-B in IVIG preparations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.