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High neutrophil : lymphocyte ratio is associated with refractory Kawasaki disease
Author(s) -
Cho HongJe,
Bak So Young,
Kim Su Yeong,
Yoo Rita,
Baek HaeSung,
Yang Seung,
Hwang IlTae,
Ban JiEun
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13240
Subject(s) - medicine , neutrophil to lymphocyte ratio , kawasaki disease , refractory (planetary science) , immunology , disease , lymphocyte , physics , artery , astrobiology
Background The clinical significance of the neutrophil : lymphocyte ratio ( NLR ) has not yet been fully elucidated in Kawasaki disease ( KD ). The purpose of this study was to investigate the relationship between NLR and response to i.v. immunoglobulin ( IVIG ), and its effect on coronary abnormalities in KD . Methods A total of 196 KD patients treated with IVIG were analyzed. Baseline NLR was evaluated immediately before IVIG therapy and the patients classified into two groups according to NLR . The clinical data, other inflammatory biomarkers, and coronary complications were also assessed. Results Kawasaki disease patients with NLR ≥ 5 had a greater incidence of IVIG refractoriness than the NLR < 5 group (31.7% vs 4.3%, P < 0.001), but this was not related to the development of coronary abnormalities. The change in NLR after IVIG (i.e. Δ NLR ) was significantly decreased in the coronary abnormality group (2.65 ± 1.88 vs 3.81 ± 2.55, P = 0.042). On multivariate analysis, high NLR and CRP were independent predictors of IVIG refractoriness during the acute phase of KD ( P = 0.032 in NLR ; P = 0.029 in CRP , respectively). Conclusions High NLR was closely associated with resistance to IVIG , but it was not related to the occurrence of coronary abnormalities in KD . Low Δ NLR after IVIG , however, was significantly associated with coronary artery abnormalities.