Serum coagulation levels for predicting initial IVIG resistance
As shown in Table 1, there were no significant differences in age, sex, the day of illness before IVIG treatment, sampling day of illness, and typical clinical manifestations between the initial IVIG-responsive and IVIG-resistant groups. As for other cardiac complications, the percentage of patients with cardiac enlargement and pericardial effusion was found to be significantly higher in the initial IVIG-resistant group (p=0.003 and p=0.016, respectively). Initial IVIG-resistant patients had much higher incidence of CALs, with substantial higher level of serum C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), serum total bilirubin (TB), serum alanine aminotransferase (ALT), creatinine, urea nitrogen, but with lower hemoglobin, platelet count, albumin, sodium, potassium before the initial IVIG treatment (all P < 0.005). No significant differences were found in the white blood cell count, erythrocyte sedimentation rate, and aspartate aminotransferase between the two groups.
The effect of KD on the coagulation system was evaluated by assessing the coagulation profiles of initial IVIG-responsive and IVIG-resistant subjects. The PT (14.3 [13.6-15.5] s vs. 13.8 [13-14.4] s, p=0.005) and APTT (35.3 [31.9-44.7] s vs. 34.2 [30.7-38.1] s, p=0.006) were significantly longer in the initial IVIG-resistant group, with significantly higher D-dimer levels (2.1 [1.20-2.82] mg/l vs. 1.2 [0.8-2.07] mg/l, p=0.020) as well as ATIII activity (81% [65-88%] vs. 89% [81-100%], p<0.001) (Table 1).