JCK Poster 2 (II-JCKP2)
Kawasaki Disease/General Cardiology/Adult Congenital Heart Disease

[II-JCKP2-03] The level of serum TNF-a in intravenous immunoglobulin non-responsive children with Kawasaki disease

^○Wang Yun¹, Cui Dai² (1.Department of pediatrics, Beijing new century women's and children's hospital, Beijing, China, 2.Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China)

Objective Study TNF-a levels in 131 KD patients，help to identify risk factor of IVIG non-responsiveness, and explore further treatment. Methods KD patients were divided into non-responsive and sensitive group，28 healthy and 16 fe­brile patients were also recruited. Results 1) Proportion of CAA (30.0% vs. 7.2%) in the non-responsive group was significantly higher than those in sensitive group (p<0.01); Proportion of cardiomegaly in the non-responsive group was also significantly higher than that in the sensitive group at acute phase (p<0.01); IVIG non-responsiveness was an independent risk factor for cardiovascular complications.2) The high TNF-a levels existed in KD, and there was a statistical difference in KD patients compared with healthy children, and febrile controls，respectively (p＜0.01). 3) Before therapy, TNF-a was 128.65（97.45， 251.88）pg/ml VS 44.20（21.00，125.78）pg/ml; there was a statistical difference within non-responsive and sensitive group (p<0.01). The elevation of TNF-a continually existed in the non-responsive group after initial IVIG ，there was also a statistical difference between them (p<0.05). 4) Male, TNF-a＞100 pg/ml and ALB were independent risk factors associated with IVIG re-treatment. Conclusions High TNF-a levels existed in KD. IVIG could allow TNF-a levels reduce, but TNF-a were continually elevated in the non-responsive group after initial IVIG. IVIG non-responsiveness was an independent risk factor for cardiovascular complications. Risk factors associated with IVIG re-treatment include Male sex and the high level of TNF-a.