Expert consensus on the use of intravenous immunoglobulin in children with Kawasaki disease

Shaanxi Provincial Diagnosis and Treatment Center of Kawasaki Disease

Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (9) : 867-876.

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Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (9) : 867-876. DOI: 10.7499/j.issn.1008-8830.2107110
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Expert consensus on the use of intravenous immunoglobulin in children with Kawasaki disease

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Abstract

Kawasaki disease is an acute, self-limited vascuitis that mainly occurs in children under 5 years of age. Intravenous immunoglobulin (IVIG) has become an effective treatment regimen, which can effectively reduce the incidence of cardiovascular complications. However, there has been no consensus or clinical guidelines for the application of IVIG in children with Kawasaki disease till now. This consensus is developed based on the current research progress on the application of IVIG in children with Kawasaki disease in China and overseas, with reference to the diagnosis and treatment guidelines for Kawasaki disease in China and overseas, and the opinions of experts. This consensus provides recommendations on the clinical application strategy of IVIG in children with Kawasaki disease and the prevention and treatment of its adverse reactions. Citation:

Key words

Kawasaki disease / Self-limited vasculitis / Intravenous immunoglobulin / Expert consensus / Child

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Shaanxi Provincial Diagnosis and Treatment Center of Kawasaki Disease. Expert consensus on the use of intravenous immunoglobulin in children with Kawasaki disease[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(9): 867-876 https://doi.org/10.7499/j.issn.1008-8830.2107110

References

1 Ae R, Makino N, Kosami K, et al. Epidemiology, treatments, and cardiac complications in patients with Kawasaki disease: the nationwide survey in Japan, 2017-2018[J]. J Pediatr, 2020, 225: 23-29.e2. PMID: 32454114. DOI: 10.1016/j.jpeds.2020.05.034.
2 Du ZD, Zhao D, Du JB, et al. Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004[J]. Pediatr Infect Dis J, 2007, 26(5): 449-451. PMID: 17468660. DOI: 10.1097/01.inf.0000261196.79223.18.
3 Barrios Tascón A, Centeno Malfaz F, Rojo Sombrero H, et al. National consensus on the cardiological treatment and follow-up of Kawasaki disease[J]. An Pediatr (Barc), 2018, 89(3): 188.e1-188.e22. PMID: 29778491. DOI: 10.1016/j.anpedi.2018.04.003.
4 McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association[J]. Circulation, 2017, 135(17): e927-e999. PMID: 28356445. DOI: 10.1161/CIR.0000000000000484.
5 中国医师协会儿科医师分会风湿免疫学组, 中国儿童免疫与健康联盟, 《中国实用儿科杂志》编辑委员会. 儿童风湿性疾病相关巨噬细胞活化综合征诊断与治疗专家共识之一: 总论篇[J]. 中国实用儿科杂志, 2020, 35(11): 825-831. DOI: 10.19538/j.ek2020110601.
6 Marchesi A, Rigante D, Cimaz R, et al. Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease[J]. Ital J Pediatr, 2021, 47(1): 16. PMID: 33494789. PMCID: PMC7830049. DOI: 10.1186/s13052-021-00962-4.
7 Fukazawa R, Kobayashi J, Ayusawa M, et al. JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease[J]. Circ J, 2020, 84(8): 1348-1407. PMID: 32641591. DOI: 10.1253/circj.CJ-19-1094.
8 Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association[J]. Circulation, 2004, 110(17): 2747-2771. PMID: 15505111. DOI: 10.1161/01.CIR.0000145143.19711.78.
9 Miyata K, Miura M, Kaneko T, et al. Risk factors of coronary artery abnormalities and resistance to intravenous immunoglobulin plus corticosteroid therapy in severe Kawasaki disease: an analysis of post RAISE[J]. Circ Cardiovasc Qual Outcomes, 2021, 14(2): e007191. PMID: 33541111. DOI: 10.1161/CIRCOUTCOMES.120.007191.
10 Suzuki T, Michihata N, Aso S, et al. Sodium-containing versus sodium-trace preparations of IVIG for children with Kawasaki disease in the acute phase[J]. Eur J Pediatr, 2021. PMID: 33973071. DOI: 10.1007/s00431-021-04096-x. Epub ahead of print.
11 黄笛, 黄瑞秀, 郭晨煜, 等. 临床实践指南制定方法——证据分级与推荐强度[J]. 中国循证心血管医学杂志, 2018, 10(7): 769-776. DOI: 10.3969/j.issn.1674-4055.2018.07.01.
12 BalshemH, HelfandaM, SchunemannHJ, 等. GRADE指南: Ⅲ. 证据质量分级[J]. 中国循证医学杂志, 2011, 11(4): 451-455. DOI: 10.3969/j.issn.1672-2531.2011.04.017.
13 Shimoni Z, Bulvik S, Froom P. Intravenous immune globulin in autoimmune and inflammatory diseases[J]. N Engl J Med, 2013, 368(8): 776-777. PMID: 23425182. DOI: 10.1056/NEJMc1215489.
14 Imbach P, Barandun S, Baumgartner C, et al. High-dose intravenous gammaglobulin therapy of refractory, in particular idiopathic thrombocytopenia in childhood[J]. Helv Paediatr Acta, 1981, 36(1): 81-86. PMID: 6785258.
15 Newburger JW, Takahashi M, Burns JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin[J]. N Engl J Med, 1986, 315(6): 341-347. PMID: 2426590. DOI: 10.1056/NEJM198608073150601.
16 Teeling JL, Jansen-Hendriks T, Kuijpers TW, et al. Therapeutic efficacy of intravenous immunoglobulin preparations depends on the immunoglobulin G dimers: studies in experimental immune thrombocytopenia[J]. Blood, 2001, 98(4): 1095-1099. PMID: 11493456. DOI: 10.1182/blood.v98.4.1095.
17 Furusho K, Sato K, Soeda T, et al. High-dose intravenous gammaglobulin for Kawasaki disease[J]. Lancet, 1983, 2(8363): 1359. PMID: 6196587. DOI: 10.1016/s0140-6736(83)91109-1.
18 Furusho K, Kamiya T, Nakano H, et al. High-dose intravenous gammaglobulin for Kawasaki disease[J]. Lancet, 1984, 2(8411): 1055-1058. PMID: 6209513. DOI: 10.1016/s0140-6736(84)91504-6.
19 Guo MMH, Tseng WN, Ko CH, et al. Th17- and Treg-related cytokine and mRNA expression are associated with acute and resolving Kawasaki disease[J]. Allergy, 2015, 70(3): 310-318. PMID: 25585854. DOI: 10.1111/all.12558.
20 Rasouli M, Heidari B, Kalani M. Downregulation of Th17 cells and the related cytokines with treatment in Kawasaki disease[J]. Immunol Lett, 2014, 162(1 Pt A): 269-275. PMID: 25277751. DOI: 10.1016/j.imlet.2014.09.017.
21 Royle J, Burgner D, Curtis N. The diagnosis and management of Kawasaki disease[J]. J Paediatr Child Health, 2005, 41(3): 87-93. PMID: 15790316. DOI: 10.1111/j.1440-1754.2005.00555.x.
22 Tajima M, Shiozawa Y, Kagawa J. Early appearance of principal symptoms of Kawasaki disease is a risk factor for intravenous immunoglobulin resistance[J]. Pediatr Cardiol, 2015, 36(6): 1159-1165. PMID: 25753685. DOI: 10.1007/s00246-015-1136-2.
23 Lin MC, Lai MS, Jan SL, et al. Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997-2010: effect of different case definitions in claims data analysis[J]. J Chin Med Assoc, 2015, 78(2): 121-126. PMID: 25636582. PMCID: PMC7105041. DOI: 10.1016/j.jcma.2014.03.009.
24 杜忠东, 赵地, 杜军保, 等. 静脉注射丙种球蛋白应用时间对川崎病疗效的影响[J]. 中华医学杂志, 2009, 89(26): 1841-1843. PMID: 19953930. DOI: 10.3760/cma.j.issn.0376-2491.2009.26.014.
25 Muta H, Ishii M, Yashiro M, et al. Late intravenous immunoglobulin treatment in patients with Kawasaki disease[J]. Pediatrics, 2012, 129(2): e291-e297. PMID: 22250032. DOI: 10.1542/peds.2011-1704.
26 Kuwabara M, Yashiro M, Ae R, et al.The effects of early intravenous immunoglobulin therapy for Kawasaki disease: the 22nd nationwide survey in Japan[J]. Int J Cardiol, 2018, 269(10): 334-338. PMID: 30049499. DOI: 10.1016/j.ijcard.2018.07.092.
27 Yan F, Zhang HY, Xiong RH, et al. Effect of early intravenous immunoglobulin therapy in Kawasaki disease: a systematic review and meta-analysis[J]. Front Pediatr, 2020, 8: 593435. PMID: 33330287. PMCID: PMC7715029. DOI: 10.3389/fped.2020.593435.
28 Marchesi A, Tarissi de Jacobis I, Rigante D, et al. Kawasaki disease: guidelines of the Italian Society of Pediatrics, part I - definition, epidemiology, etiopathogenesis, clinical expression and management of the acute phase[J]. Ital J Pediatr, 2018, 44(1): 102. PMID: 30157897. PMCID: PMC6116535. DOI: 10.1186/s13052-018-0536-3.
29 Gamez-Gonzalez LB, Moribe-Quintero I, Cisneros-Castolo M, et al. Kawasaki disease shock syndrome: unique and severe subtype of Kawasaki disease[J]. Pediatr Int, 2018, 60(9): 781-790. PMID: 29888440. DOI: 10.1111/ped.13614.
30 Ma L, Zhang YY, Yu HG. Clinical manifestations of Kawasaki disease shock syndrome[J]. Clin Pediatr (Phila), 2018, 57(4): 428-435. PMID: 28905639. DOI: 10.1177/0009922817729483.
31 Miura M, Ayusawa M, Fukazawa R, et al. Guidelines for medical treatment of acute Kawasaki disease (2020 revised version)[J]. J Pediatr Cardiol Card Surg, 2021, 5(1): 41-73. DOI: 10.24509/jpccs.0501G1.
32 Zhu F, Ang JY. 2021 update on the clinical management and diagnosis of Kawasaki disease[J]. Curr Infect Dis Rep, 2021, 23(3): 3. DOI: 10.1007/s11908-021-00746-1.
33 杜忠东, 赵地, 杜军保, 等. 不同静脉丙种球蛋白给药方法治疗川崎病的效果比较[J]. 中华医学杂志, 2007, 87(44): 3119-3121. PMID: 18269869. DOI: 10.3760/j.issn:0376-2491.2007.44.007.
34 张伟, 李秋, 赵晓东, 等. 942例川崎病的临床分析[J]. 中华儿科杂志, 2006, 44(5): 324-328. PMID: 16780705. DOI: 10.3760/j.issn:0578-1310.2006.05.002.
35 覃丽君, 王宏伟, 胡秀芬, 等. 静脉注射不同剂量丙种球蛋白治疗川崎病的临床研究[J]. 中华儿科杂志, 2006, 44(12): 891-895. PMID: 17254453. DOI: 10.3760/j.issn:0578-1310.2006.12.004.
36 王秋月, 和建梅, 张志敏. 不同剂量免疫球蛋白治疗川崎病的疗效观察[J]. 中原医刊, 2006, 33(3): 49-50. DOI: 10.3760/cma.j.issn.1674-4756.2006.03.035.
37 Durongpisitkul K, Gururaj VJ, Park JM, et al. The prevention of coronary artery aneurysm in Kawasaki disease: a meta-analysis on the efficacy of aspirin and immunoglobulin treatment[J]. Pediatrics, 1995, 96(6): 1057-1061. PMID: 7491221.
38 Terai M, Shulman ST. Prevalence of coronary artery abnormalities in Kawasaki disease is highly dependent on gamma globulin dose but independent of salicylate dose[J]. J Pediatr, 1997, 131(6): 888-893. PMID: 9427895. DOI: 10.1016/s0022-3476(97)70038-6.
39 Sawaji Y, Haneda N, Yamaguchi S, et al. Coronary risk factors in acute Kawasaki disease: correlation of serum immunoglobulin levels with coronary complications[J]. Acta Paediatr Jpn, 1998, 40(3): 218-225. PMID: 9695293. DOI: 10.1111/j.1442-200x.1998.tb01915.x.
40 Dajani AS, Taubert KA, Gerber MA, et al. Diagnosis and therapy of Kawasaki disease in children[J]. Circulation, 1993, 87(5): 1776-1780. PMID: 8491037. DOI: 10.1161/01.cir.87.5.1776.
41 Cherin P, Marie I, Michallet M, et al. Management of adverse events in the treatment of patients with immunoglobulin therapy: a review of evidence[J]. Autoimmun Rev, 2016, 15(1): 71-81. PMID: 26384525. DOI: 10.1016/j.autrev.2015.09.002.
42 Finkel AG, Howard JFJ, Mann JD. Successful treatment of headache related to intravenous immunoglobulin with antimigraine medications[J]. Headache, 1998, 38(4): 317-321. PMID: 9595875. DOI: 10.1046/j.1526-4610.1998.3804317.x.
43 Abolhassani H, Asgardoon MH, Rezaei N, et al. Different brands of intravenous immunoglobulin for primary immunodeficiencies: how to choose the best option for the patient?[J]. Expert Rev Clin Immunol, 2015, 11(11): 1229-1243. PMID: 26289377. DOI: 10.1586/1744666X.2015.1079485.
44 Eibl MM. History of immunoglobulin replacement[J]. Immunol Allergy Clin North Am, 2008, 28(4): 737-764. PMID: 18940572. DOI: 10.1016/j.iac.2008.06.004.
45 Ramírez E, Romero-Garrido JA, López-Granados E, et al. Symptomatic thromboembolic events in patients treated with intravenous-immunoglobulins: results from a retrospective cohort study[J]. Thromb Res, 2014, 133(6): 1045-1051. PMID: 24731561. DOI: 10.1016/j.thromres.2014.03.046.
46 Nguyen E, Hershey D, Romanowski G, et al. Intravenous immunoglobulin infusion reactions in Kawasaki disease patients who undergo sedation[J]. J Pediatr Pharmacol Ther, 2020, 25(3): 251-255. PMID: 32265610. PMCID: PMC7134588. DOI: 10.5863/1551-6776-25.3.251.
47 Berard R, Whittemore B, Scuccimarri R. Hemolytic anemia following intravenous immunoglobulin therapy in patients treated for Kawasaki disease: a report of 4 cases[J]. Pediatr Rheumatol Online J, 2012, 10(1): 10. PMID: 22507284. PMCID: PMC3353234. DOI: 10.1186/1546-0096-10-10.
48 Comenzo RL, Malachowski ME, Meissner HC, et al. Immune hemolysis, disseminated intravascular coagulation, and serum sickness after large doses of immune globulin given intravenously for Kawasaki disease[J]. J Pediatr, 1992, 120(6): 926-928. PMID: 1593353. DOI: 10.1016/s0022-3476(05)81964-x.
49 Van Anh KVY, Shah S, Tremoulet AH. Hemolysis from intravenous immunoglobulin in obese patients with Kawasaki disease[J]. Front Pediatr, 2020, 8: 146. PMID:32318529. PMCID:PMC7146618. DOI: 10.3389/fped.2020.00146.
50 Liu E, Gonzalez J, Siu A. Use of premedication with intravenous immune globulin in Kawasaki disease: a retrospective review[J]. Pediatr Allergy Immunol, 2021, 32(4): 750-755. PMID: 33326647. DOI: 10.1111/pai.13432.
51 Matsuda M, Hosoda W, Sekijima Y, et al. Neutropenia as a complication of high-dose intravenous immunoglobulin therapy in adult patients with neuroimmunologic disorders[J]. Clin Neuropharmacol, 2003, 26(6): 306-311. PMID: 14646610. DOI: 10.1097/00002826-200311000-00009.
52 Jiao FY, Yan XH, Wu XF. The Xi'an experience of Kawasaki disease: lessons learnt over 5 years[J]. Indian J Pediatr, 2016, 83(10): 1195-1196. PMID: 27094776. DOI: 10.1007/s12098-016-2100-8.
53 Singh S, Sharma A, Jiao FY. Kawasaki disease: issues in diagnosis and treatment--a developing country perspective[J]. Indian J Pediatr, 2016, 83(2): 140-145. PMID: 26400032. DOI: 10.1007/s12098-015-1890-4.
54 Jiao FY, Jindal AK, Pandiarajan V, et al. The emergence of Kawasaki disease in India and China[J]. Glob Cardiol Sci Pract, 2017, 2017(3): e201721. PMID: 29564342. PMCID: PMC5856971. DOI: 10.21542/gcsp.2017.21.
55 Katz U, Achiron A, Sherer Y, et al. Safety of intravenous immunoglobulin (IVIG) therapy[J]. Autoimmun Rev, 2007, 6(4): 257-259. PMID: 17317619. DOI: 10.1016/j.autrev.2006.08.011.
56 廉世宽.丙种球蛋白治疗小儿川崎病的临床疗效及其安全性[J].临床合理用药杂志, 2021, 14(12): 112-114. DOI: 10.15887/j.cnki.13-1389/r.2021.12.041.
57 李艳钰. IVIG联合糖皮质激素治疗IVIG无反应型川崎病临床疗效与安全性的循证医学评价[D]. 泸州: 西南医科大学, 2018.
58 李丹, 冯媛, 耿玲玲, 等. 小剂量甲基泼尼松龙联合静脉丙种球蛋白治疗静脉丙种球蛋白无反应型川崎病的疗效分析[J]. 中国全科医学, 2019, 22(4): 442-446. DOI: 10.12114/j.issn.1007-9572.2019.04.015.
59 Cao W, Liu XS, Hong K, et al. High-Dose intravenous immunoglobulin in severe coronavirus disease 2019: a multicenter retrospective study in China[J]. Front Immunol, 2021, 12: 627844. PMID: 33679771. PMCID: PMC7933558. DOI: 10.3389/fimmu.2021.627844.
60 McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association[J]. Circulation, 2017, 135(17): e927-e999. PMID: 28356445. DOI: 10.1161/CIR.0000000000000484.
61 熊祎, 张永兰, 杜忠东. 川崎病合并巨大冠状动脉瘤101例中长期随访[J]. 中华儿科杂志, 2021, 59(2): 101-106. PMID: 33548955. DOI: 10.3760/cma.j.cn112140-20201124-01052.
62 相虹, 常明, 王秋霞, 等. 川崎病患儿治疗前后血清脂源性细胞因子的变化及意义[J]. 中国当代儿科杂志, 2020, 22(1): 53-57. PMID: 31948525. PMCID: PMC7389719. DOI: 10.7499/j.issn.1008-8830.2020.01.011.
63 杜忠东, 陈笑征. 川崎病流行病学研究进展[J]. 中国实用儿科杂志, 2017, 32(8): 565-569. DOI: 10.19538/j.ek2017080602.
64 任玉梅. 不同剂量丙种球蛋白治疗川崎病[J]. 中国实用医刊, 2011, 38(9): 74. DOI: 10.3760/cma.j.issn.1674-4756.2011.09.036.
65 李菲, 周娟, 丁媛, 等. 单中心6年川崎病住院患儿早期并发冠状动脉瘤危险因素分析[J]. 中华实用儿科临床杂志, 2019, 34(9): 680-683. DOI: 10.3760/cma.j.issn.2095-428X.2019.09.010.
66 Soni PR, Noval Rivas M, Arditi M. A comprehensive update on Kawasaki disease vasculitis and myocarditis[J]. Curr Rheumatol Rep, 2020, 22(2): 6. PMID: 32020498. DOI: 10.1007/s11926-020-0882-1.
67 Nasr I, Tometzki AJ, Schofield OM. Kawasaki disease: an update[J]. Clin Exp Dermatol, 2001, 26(1): 6-12. PMID: 11260168. DOI: 10.1046/j.1365-2230.2001.00749.x.
68 Sosa T, Brower L, Divanovic A. Diagnosis and management of Kawasaki disease[J]. JAMA Pediatr, 2019, 173(3): 278-279. PMID: 30667467. DOI: 10.1001/jamapediatrics.2018.3307.
69 王文, 罗钢, 张乾忠. 川崎病并发冠状动脉损害19例临床分析[J]. 中国实用儿科杂志, 2016, 31(11): 843-846. DOI: 10.7504/ek2016110611.
70 张亚杰, 李亚蕊. 川崎病治疗新进展及可能的机制[J]. 中华临床医师杂志(电子版), 2017, 11(6): 1037-1041. DOI: 10.3877/cma.j.issn.1674-0785.2017.06.032.
71 Samadli S, Liu FF, Mammadov G, et al. The time option of IVIG treatment is associated with therapeutic responsiveness and coronary artery abnormalities but not with clinical classification in the acute episode of Kawasaki disease[J]. Pediatr Rheumatol Online J, 2019, 17(1): 53. PMID: 31366406. PMCID: PMC6668082. DOI: 10.1186/s12969-019-0352-3.
72 Zheng XL, Yue P, Liu L, et al. Efficacy between low and high dose aspirin for the initial treatment of Kawasaki disease: current evidence based on a meta-analysis[J]. PLoS One, 2019, 14(5): e0217274. PMID: 31117119. PMCID: PMC6531010. DOI: 10.1371/journal.pone.0217274.
73 Ferreira D, Ng R, Lai E, et al. Kawasaki disease in the Australian population: an Australian tertiary hospital experience[J]. Heart Lung Circ, 2021, 30(7): 996-1001. PMID: 33612428. DOI: 10.1016/j.hlc.2020.12.016.
74 Vervoort D, Donné M, Van Gysel D. Pitfalls in the diagnosis and management of Kawasaki disease: an update for the pediatric dermatologist[J]. Pediatr Dermatol, 2018, 35(6): 743-747. PMID: 30338568. DOI: 10.1111/pde.13620.
75 Pilania RK, Bhattarai D, Singh S. Controversies in diagnosis and management of Kawasaki disease[J]. World J Clin Pediatr, 2018, 7(1): 27-35. PMID: 29456929. PMCID: PMC5803562. DOI: 10.5409/wjcp.v7.i1.27.
76 胡秀芬, 温宇. 丙种球蛋白无反应型川崎病的发病机制及治疗进展[J]. 中华实用儿科临床杂志, 2017, 32(21): 1612-1616. DOI: 10.3760/cma.j.issn.2095-428X.2017.21.004.
77 Kobayashi T, Inoue Y, Takeuchi K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease[J]. Circulation, 2006, 113(22): 2606-2612. PMID: 16735679. DOI: 10.1161/CIRCULATIONAHA.105.592865.
78 Egami K, Muta H, Ishii M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease[J]. J Pediatr, 2006, 149(2): 237-240. PMID: 16887442. DOI: 10.1016/j.jpeds.2006.03.050.
79 Sano T, Kurotobi S, Matsuzaki K, et al. Prediction of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment[J]. Eur J Pediatr, 2007, 166(2): 131-137. PMID: 16896641. DOI: 10.1007/s00431-006-0223-z.
80 吴美, 王川, 华益民, 等. 川崎病静脉注射免疫球蛋白抵抗评分系统研究进展[J]. 中华妇幼临床医学杂志(电子版), 2017, 13(1): 99-104. DOI: 10.3877/cma.j.issn.1673-5250.2017.01.018.
81 Liu GY, Wang SY, Du ZD. Risk factors of intravenous immunoglobulin resistance in children with Kawasaki disease: a meta-analysis of case-control studies[J]. Front Pediatr, 2020, 8: 187. PMID: 32373568. PMCID: PMC7186309. DOI: 10.3389/fped.2020.00187.
82 Friedman KG, Jone PN. Update on the management of Kawasaki disease[J]. Pediatr Clin North Am, 2020, 67(5): 811-819. PMID: 32888683. DOI: 10.1016/j.pcl.2020.06.002.
83 Pilania RK, Jindal AK, Guleria S, et al. An update on treatment of Kawasaki disease[J]. Curr Treat Options Rheum, 2019, 5(1): 36-55. DOI: 10.1007/s40674-019-00115-z.
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