Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion

Abstract Background Kawasaki disease (KD) primarily affects young children and can lead to coronary artery lesions. Intravenous immunoglobulin (IVIG) treatment is essential; however, it may fail in 10-20% of cases, increasing the risk of complications. Complete blood count (CBC) tests can help asses...

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Main Authors: Junshan Zhao, Yingying Ma, Li Xin, Lijun Wang, Hongliang Gao
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-01891-2
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author Junshan Zhao
Yingying Ma
Li Xin
Lijun Wang
Hongliang Gao
author_facet Junshan Zhao
Yingying Ma
Li Xin
Lijun Wang
Hongliang Gao
author_sort Junshan Zhao
collection DOAJ
description Abstract Background Kawasaki disease (KD) primarily affects young children and can lead to coronary artery lesions. Intravenous immunoglobulin (IVIG) treatment is essential; however, it may fail in 10-20% of cases, increasing the risk of complications. Complete blood count (CBC) tests can help assess disease severity and predict risks. This study investigated the impact of IVIG on peripheral blood cells, including neutrophil count, platelet-lymphocyte ratio, hemoglobin level, mean platelet volume (MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), in children with KD complicated by coronary artery lesions (CALs). Methods This retrospective analysis included children diagnosed with typical KD. The neutrophil count, hemoglobin level, platelet-lymphocyte ratio, MPV, ESR, and CRP were compared between those with (CAL+) and without (CAL−) CALs during the acute phase, as well as at 7 days, 1 month, and 2 months after normalizing body temperature with IVIG. Results A total of 76 children with KD were analyzed, including 30 with CAL+. CAL+ and CAL− patients exhibited elevated neutrophil counts during the acute phase, with no significant differences (P > 0.05) between groups. After IVIG treatment, CAL− patients demonstrated a more pronounced reduction in neutrophil count (P < 0.05) than CAL+ patients. Hemoglobin levels differed significantly during the acute phase (P < 0.05) but were comparable post-treatment (P > 0.05) between CAL+ and CAL− patients. The platelet-lymphocyte ratio varied significantly between groups during the acute phase and 1-month post-treatment (P < 0.05). Mean ESR and CRP levels were significantly elevated at all time points in the CAL+ group compared with the CAL− group. No significant differences in MPV were observed between groups. Conclusions After IVIG treatment, CAL− patients demonstrated a more important reduction in neutrophil count than CAL+ patients after IVIG. Pediatric patients with KD and CAL+ showed lower hemoglobin and platelet-lymphocyte ratio and higher ESR and CRP compared with CAL−, suggesting that they may serve as indicators for CAL in pediatric patients with KD.
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spelling doaj-art-70d52d510b904c929e30cf87f7c8c9fa2025-08-20T02:43:16ZengBMCItalian Journal of Pediatrics1824-72882025-02-015111810.1186/s13052-025-01891-2Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesionJunshan Zhao0Yingying Ma1Li Xin2Lijun Wang3Hongliang Gao4Department of Intensive Care Medicine Division 2, Hebei Children’s HospitalDepartment of Intensive Care Medicine Division 2, Hebei Children’s HospitalDepartment of Intensive Care Medicine Division 2, Hebei Children’s HospitalDepartment of Intensive Care Medicine Division 2, Hebei Children’s HospitalDepartment of Intensive Care Medicine Division 2, Hebei Children’s HospitalAbstract Background Kawasaki disease (KD) primarily affects young children and can lead to coronary artery lesions. Intravenous immunoglobulin (IVIG) treatment is essential; however, it may fail in 10-20% of cases, increasing the risk of complications. Complete blood count (CBC) tests can help assess disease severity and predict risks. This study investigated the impact of IVIG on peripheral blood cells, including neutrophil count, platelet-lymphocyte ratio, hemoglobin level, mean platelet volume (MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), in children with KD complicated by coronary artery lesions (CALs). Methods This retrospective analysis included children diagnosed with typical KD. The neutrophil count, hemoglobin level, platelet-lymphocyte ratio, MPV, ESR, and CRP were compared between those with (CAL+) and without (CAL−) CALs during the acute phase, as well as at 7 days, 1 month, and 2 months after normalizing body temperature with IVIG. Results A total of 76 children with KD were analyzed, including 30 with CAL+. CAL+ and CAL− patients exhibited elevated neutrophil counts during the acute phase, with no significant differences (P > 0.05) between groups. After IVIG treatment, CAL− patients demonstrated a more pronounced reduction in neutrophil count (P < 0.05) than CAL+ patients. Hemoglobin levels differed significantly during the acute phase (P < 0.05) but were comparable post-treatment (P > 0.05) between CAL+ and CAL− patients. The platelet-lymphocyte ratio varied significantly between groups during the acute phase and 1-month post-treatment (P < 0.05). Mean ESR and CRP levels were significantly elevated at all time points in the CAL+ group compared with the CAL− group. No significant differences in MPV were observed between groups. Conclusions After IVIG treatment, CAL− patients demonstrated a more important reduction in neutrophil count than CAL+ patients after IVIG. Pediatric patients with KD and CAL+ showed lower hemoglobin and platelet-lymphocyte ratio and higher ESR and CRP compared with CAL−, suggesting that they may serve as indicators for CAL in pediatric patients with KD.https://doi.org/10.1186/s13052-025-01891-2Intravenous immunoglobulinCoronary arteriesKawasaki diseasePeripheral blood cells
spellingShingle Junshan Zhao
Yingying Ma
Li Xin
Lijun Wang
Hongliang Gao
Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
Italian Journal of Pediatrics
Intravenous immunoglobulin
Coronary arteries
Kawasaki disease
Peripheral blood cells
title Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
title_full Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
title_fullStr Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
title_full_unstemmed Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
title_short Impact of intravenous immunoglobulin treatment on peripheral blood cells in children with Kawasaki disease complicated with coronary artery lesion
title_sort impact of intravenous immunoglobulin treatment on peripheral blood cells in children with kawasaki disease complicated with coronary artery lesion
topic Intravenous immunoglobulin
Coronary arteries
Kawasaki disease
Peripheral blood cells
url https://doi.org/10.1186/s13052-025-01891-2
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