講演情報
[I-P03-2-01]Utility of Complete Blood Count-Derived Inflammatory Markers for Predicting IVIG Resistance in Infant Kawasaki Disease
○Young Tae Lim (Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea)
キーワード：
Mucocutaneous Lymph Node Syndrome、Drug Resistance、Inflammation
Background and Objectives: Kawasaki disease (KD) in infants presents unique challenges with higher rates of intravenous immunoglobulin (IVIG) resistance and coronary complications. This study aimed to evaluate the predictive value of complete blood count-derived inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and pan-immune inflammation value (PIV) for IVIG resistance in infants under 12 months with KD. Methods: We retrospectively analyzed 261 infants diagnosed with KD between January 2014 and December 2024. The predictive values of inflammatory markers were evaluated using receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify independent predictors of IVIG resistance.Results: Among the study population, 67 patients (25.7%) showed IVIG resistance. MLR showed the highest predictive performance (AUC 0.776, 95% CI: 0.706-0.845), followed by NLR (AUC 0.738, 95% CI: 0.670-0.806) and PIV (AUC 0.734, 95% CI: 0.658-0.811). In multivariate analysis, MLR >0.21 (OR 3.45, 95% CI: 1.66-7.14), PIV >726.68 (OR 2.30, 95% CI: 1.14-4.67), and elevated total bilirubin (OR 1.96, 95% CI: 1.02-3.79) were independent predictors of IVIG resistance. Coronary artery lesions were significantly more frequent in IVIG-resistant patients (16.4% vs 5.2%, p=0.007).Conclusions: MLR is the strongest predictor of IVIG resistance in infant KD, suggesting its potential utility as a simple and cost-effective screening tool for risk stratification in this high-risk population.