Utility of ferritin as a predictor of the patients with Kawasaki disease refractory to intravenous immunoglobulin therapy

Abstract

Objectives. The aim of this study is to investigate whether ferritin can be a useful marker for the prediction of the patients with Kawasaki disease (KD) refractory to initial intravenous immunoglobulin (IVIG) therapy.

Methods. This retrospective study enrolled 85 patients with KD hospitalized at Kitakyushu General Hospital during 2010–2014. These patients were divided into IVIG responders (n = 57) and non-responders (n = 28). Serum ferritin levels and the scoring systems for the prediction of non-responsiveness to initial IVIG therapy were compared between these two groups.

Results. Serum ferritin level was significantly elevated in non-responders (p = 0.010). The area under the receiver-operating characteristics curve was 0.674, and the sensitivity and specificity in more than 165 ng/ml of serum ferritin level were 70.4% and 63.2%, respectively. In two of the three prediction scoring systems, non-responders also showed significantly higher scores than responders, but many non-responders had low scores of these scoring systems. More than half of the patients with a low score of these scoring systems had high serum ferritin level (≥ 165 ng/ml).

Conclusions. Serum ferritin level might be a useful marker for the prediction of non-responsiveness to initial IVIG therapy and could be an important complementary marker to the prediction scoring systems.

Keywords:

• Ferritin
• Intravenous immunoglobulin therapy
• Refractory Kawasaki disease

Conflict of interest

None.