Original Article

Impact of D-Dimer on the Resistance to Intravenous Immunoglobulin Therapy in Kawasaki Disease

Author: Masayuki Nagasawa

Aim: To investigate the impact of D-dimer on the resistance to intravenous immunoglobulin therapy (IVIG) in Kawasaki Disease Patients: From 2013 through 2016, 225 patients were newly diagnosed as Kawasaki Disease at our institute. Among them, Kobayashi score (K-score) was available for 203 patients, and D-dimer before treatment was measured in 131 patients, in which 119 patients were initially treated with IVIG. These 119 patients were analyzed. Results: K-score was not associated with IVIG resistance efficiently (odds ratio of 1.78, 95%CI: 0.68-4.69, p = 0.24). However, odds ratio was improved to 2.52 (95%CI: 0.88-7.25, p = 0.08) for 101 patients in which D-dimer was < 2.5μg/mL. On the contrary, D-dimer value >= 2.5μg/mL was associated with IVIG resistance with odds ratio of 3.26 (95%CI: 1.17-9.10, p = 0.02) and D-dimer value >=4.0μg/μL with odds ratio of 5.98 (95%CI: 1.10-32.42, p = 0.02) as an independent factor. Conclusion: Association of K-score with IVIG resistance is limited, and elevated D-dimer before treatment is a significant independent risk factor for IVIG resistance even in the patients with low K-score.