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Master Thesis

Performances du score Kawanet et étude des facteurs de résistances aux immunoglobulines intraveineuses dans une cohorte multiethnique monocentrique d'enfants français atteints de la maladie de Kawasaki

Abstract : Objectives: 10 to 20% of patients with Kawasaki disease are refractory to initial intravenous immunoglobulin (IVIg) therapy, and are at highest risk of developing coronary artery abnormalities. Early identification of these patients is crucial to intensify initial treatment. Scoring systems to predict IVIG resistance showed insufficient performances in non-Japanese populations. The main objective is to study the French Kawanet score recently described, on an independent multiethnic population. Materials and methods: we retrospectively reviewed medical records of all children with Kawasaki disease at the Bordeaux University Hospital in France, between 2006 and 2020. Scoring systems to predict IVIg resistance, Kawanet and three Japanese tests, were studied. Factors associated with resistance to IVIG in our population have been identified by multivariate analysis. Results: overall, 119 children were included. 16% of patients were unresponsive to the initial IVIg treatment. Kawanet score showed a sensitivity of 44%, and a specificity of 74%. Kobayashi’s score had interesting performances in the North Africa / Middle East subgroup of children. Significant predictors of IVIg unresponsiveness were a delay between “onset of fever and treatment with IVIg” ≤ 5 days, and presence of coronary artery abnormalities at one month after diagnosis. Conclusion: in our multi-ethnic French population with Kawasaki disease, performances of Kawanet score were insufficient to detect patients refractory to initial IVIg therapy.
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https://dumas.ccsd.cnrs.fr/dumas-03382274
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Submitted on : Monday, October 18, 2021 - 10:31:38 AM
Last modification on : Thursday, November 25, 2021 - 3:15:46 AM

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  • HAL Id : dumas-03382274, version 1

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Camille Bertho. Performances du score Kawanet et étude des facteurs de résistances aux immunoglobulines intraveineuses dans une cohorte multiethnique monocentrique d'enfants français atteints de la maladie de Kawasaki. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03382274⟩

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