ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG2022
Predicting Intravenous Immunoglobulin Resistance Among North American Children Hospitalized With Kawasaki Disease.
Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality and performance of machine learning versus logistic regression for predicting IVIG resistance in Kawasaki disease: a PROBAST+AI systematic comparison.BMC medical research methodology · 2026Pooled it
- Development and validation of a novel interpretable machine learning model integrating immune-inflammatory indicators for intravenous immunoglobulin resistance in Kawasaki disease.Translational pediatrics · 2026Article
- Hepatobiliary involvement in Kawasaki disease: from cholestatic hepatitis to the hepatic vascular-biliary unit hypothesis-a state-of-the-art review.Frontiers in immunology · 2026Review
- Development and Validation of Multivariable Machine-Learning Models for the Prediction of Multisystemic Inflammatory Syndrome Outcomes in Latin American Children.Acta paediatrica (Oslo, Norway : 1992) · 2026Observational
- Nutrition-Associated Biomarkers in Predicting Intravenous Immunoglobulin Resistance and Coronary Artery Lesions in Kawasaki Disease: A Systematic Review and Meta-Analysis.Food science & nutrition · 2025Review
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4 authors.
Funding
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Abstract
objectiveThe Kobayashi score (KS) is the most widely used tool for predicting intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD). The KS has shown good sensitivity (86%) and specificity (68%) in Japanese children; however, its use is limited outside of Japan. No models accurately predict IVIG resistance of children with KD in the United States. We sought to develop and test a novel scoring system to predict IVIG resistance in hospitalized children with KD.
methodsA retrospective chart review was conducted of all children diagnosed with KD from January 2000 to December 2015. Subjects were divided into 2 groups: IVIG susceptible or resistant. Variables that differed between the groups were identified and used to create a "new score" to predict resistance to IVIG. The new score was then compared with the KS and performance characteristics were determined.
resultsA total of 208 subjects were reviewed. White blood cell count, neutrophil percentage, age, and serum albumin were used in the new score with equal weighting. Overall, the new score achieved improved sensitivity (54% vs 26%) and similar specificity (69% vs 74%) compared with the KS in predicting IVIG resistance in hospitalized children diagnosed with KD.
conclusionsPredicting IVIG resistance in children diagnosed with KD remains challenging. The KS has low sensitivity in predicting IVIG resistance in children with KD in the United States. The new score resulted in improved sensitivity, but many children with true IVIG resistance may be missed. Further research is needed to improve IVIG resistance prediction.
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