Evaluation of the Neutrophil to Lymphocyte Ratio in the Patients of Kawasaki Disease Resistant to Intravenous immunoglobulin (IVIg) Therapy

Abstract

Background & Aims: Kawasaki disease is a systemic vasculitis of unknown etiology that is common in the pediatric patients. The primary therapeutic strategy includes aspirin and Intravenous Immunoglobulin. The present study aimed to investigate the Neutrophil to Lymphocyte Ratio (NLR) in the patients with Kawasaki and its relationship with the resistance to IVIg therapy. Materials and Methods: The present study included the patients presenting to the Motahari Hospital, Urmia, Iran, whom diagnosed with Kawasaki disease and received IVIg during 2008-2019. The authors collected the data from the patients' medical records and re-assessed the patients' data for meeting the diagnostic criteria for Kawasaki. Afterward, the data of eligible patients entered the analysis. Results: The data from 460 patients were obtained and assessed for meeting the diagnostic criteria for Kawasaki. Of 460 patients, 241 met the eligibility criteria, and the data for other patients that meet exclusion criteria were excluded from the study. According to the results of our study, response to IVIg therapy had a significant relationship with the variables of blood and urinary leukocyte counts (p=0.013 and p=0.01, respectively). However, we didn’t find any significant relationship between the response to IVIg therapy and the variables of age, gender, NLR, neutrophil count, lymphocyte count, C-Reactive Protein (CRP), serum albumin level, ALT, hemoglobin, platelet count, and the interval between onset of symptoms and treatment initiation. Conclusion: High blood leukocyte count along with low urinary leukocyte count can predict the response to IVIg treatment and subsequent prognosis in the patients affected by the Kawasaki disease. However, the NLR did not show clinical relevance.