Key result
In a Cypriot cohort of pediatric patients with Kawasaki disease, the Kobayashi and Egami scoring systems demonstrated low sensitivity (57.1% and 61.9%, respectively) for predicting IVIG resistance.
Why the study?
Kawasaki disease is a leading cause of acquired heart disease in children, but no previous studies had evaluated its epidemiology, treatment resistance, or cardiac complications in Cyprus.
Cohort (n=136)
Yes
The Kobayashi and Egami scoring systems have low sensitivity for predicting IVIG resistance in Cypriot children with Kawasaki disease, suggesting they may not be generalizable to this population.
Background: Kawasaki disease (KD) is one of the most common vasculitides of early childhood and the first cause of acquired heart disease in developed countries. There are no previous studies on KD in Cyprus. The aim of this study was to evaluate the epidemiology of KD in Cyprus, risk factors for resistance to treatment and the development of cardiac complications. Lastly, the Kobayashi and Egami scoring systems were evaluated in our population.Methods: This is a retrospective multicenter study of pediatric patients with KD hospitalized between January 2000 and-December 2019. The data were collected from medical records. Results: A total of 136 patients with KD were included in the study. 83% of patients were <5 years of age and 10% were <6 months. Median duration of fever before treatment was 6 days. 108/129 patients responded to initial treatment with IVIG. Thirty patients (22%) developed coronary artery lesions. Serum sodium ≤133mmol/L, albumin ≤ 3.2 g/dl, ALT≥ 80 U/L and neutrophils percentage≥ 80% at diagnosis, were identified as risk factors for resistance to IVIG. The Kobayashi and Egami scoring systems had low sensitivity of 57% and 62% respectively and a medium specificity of 76% and 76% respectively in predicting IVIG resistance.Conclusion: Clinical and epidemiological characteristics of KD in Cyprus population were similar to those reported in the literature. Although the majority of cases received appropriate treatment in time, cardiac complications still occurred. The Kobayashi and Egami scoring systems cannot be used in our population in order to predict responsiveness to IVIG.
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Koliou et al. (2021) conducted a cohort in Kawasaki disease (n=136). Kobayashi scoring system was evaluated on Sensitivity for predicting IVIG resistance (95% CI 34.0-78.2). In a Cypriot cohort of pediatric patients with Kawasaki disease, the Kobayashi and Egami scoring systems demonstrated low sensitivity (57.1% and 61.9%, respectively) for predicting IVIG resistance.
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