Novel risk scoring system for predicting intravenous immunoglobulin resistance and coronary artery aneurysm in Thai children with Kawasaki disease
Authors' conclusion
NLR, NLPR and TB are strong predictors of IVIG resistance, while younger age, delayed IVIG treatment, and high CRP are key predictors of CAA.
Study context
- Population
- Thai children with Kawasaki disease, January 2012 to September 2024
- Participants
- 150 children
- Outcome
- IVIG resistance and coronary artery aneurysm (CAA) development
Methodological detailsrisk score development, multivariable logistic regression
- Risk score development
- Multivariable logistic regression
Main finding
As reported in the abstract
IVIG resistance: incidence, independent predictors and risk score
- Intravenous immunoglobulin (IVIG) resistance incidence
- 12.9%
- Neutrophil-to-lymphocyte ratio (NLR) ≥ 3.5, aOR
- 25.0 (95% CI 2.92-214.3)
- Neutrophil-to-lymphocyte platelet ratio (NLPR) ≥ 1.8, aOR
- 11.83 (95% CI 2.24-62.28)
- Total bilirubin ≥ 0.9 mg/dL, aOR
- 3.51 (95% CI 1.21-10.23)
- New IVIG resistance risk score, AUC
- 0.84 (95% CI 0.74-0.95)
Observational data: associations, not effects.
Further findings
Coronary artery aneurysm (CAA): incidence, independent predictors and risk score
- CAA incidence
- 31.6%
- Age ≤ 6 months, aOR
- 2.77 (95% CI 1.02-7.50)
- Illness duration before IVIG ≥ 10 days, aOR
- 5.31 (95% CI 2.09-13.49)
- C-reactive protein (CRP) ≥ 10 mg/dL, aOR
- 2.54 (95% CI 1.08-5.97)
- New CAA risk score, AUC
- 0.74 (95% CI 0.64-0.83)
Original publication
Novel risk scoring system for predicting intravenous immunoglobulin resistance and coronary artery aneurysm in Thai children with Kawasaki disease. Pediatr Rheumatol Online J. Published 29 December 2025. doi:10.
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