Pediatrics · 1 h ago
Post-IVIG hypothermia linked to less second-line therapy in Kawasaki disease
A single-center retrospective cohort study of 557 patients with Kawasaki disease who became afebrile within 48 hours of intravenous immunoglobulin (IVIG) found that post-treatment hypothermia was associated with less frequent use of second-line therapy. The authors say prospective studies are needed to clarify the clinical significance.
- Hypothermia occurred in 58.2% of included patients.
- Second-line therapy: 14.2% with versus 28.3% without hypothermia.
- Adjusted odds ratio was 0.39 (95% CI, 0.25–0.62).
- Prospective studies are needed to clarify clinical significance.
Researchers retrospectively reviewed patients admitted with Kawasaki disease to Matsudo City General Hospital in Japan between 2018 and 2023. The analysis included 557 of 1,063 screened patients who achieved a temperature below 37.5 °C within 48 hours after IVIG. Hypothermia was defined as a temperature below 36.0 °C during that period; the primary outcome was receipt of second-line treatment.
Hypothermia occurred in 324 patients (58.2%). Second-line therapy was given to 14.2% of patients with hypothermia and 28.3% of those without it. After adjustment for age, sex, Gunma score and concomitant medications, hypothermia was associated with lower odds of second-line treatment (adjusted odds ratio, 0.39; 95% CI, 0.25–0.62). Findings were consistent using a 35.5 °C threshold. At 35.0 °C, none of seven patients with hypothermia received second-line therapy, so an odds ratio could not be estimated.
The findings describe an association in a selected group of patients at one center, not evidence that hypothermia predicts treatment response or should guide decisions. The authors call for prospective studies to establish the clinical significance of post-IVIG temperature patterns.
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Clinical Rheumatology: Association between post-intravenous immunoglobulin hypothermia and lower receipt of second-line therapy in Kawasaki disease: a single-center retrospective cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.