# Predictors of Intravenous Immunoglobulin Non‐Responsiveness in Children With Kawasaki Disease

## TL;DR

This study finds that the systemic immune-inflammation index (SII) is a better predictor of poor response to immunoglobulin treatment in children with Kawasaki disease than other blood markers.

## Contribution

The study identifies SII as a more effective predictor of IVIG non-responsiveness in Kawasaki disease compared to NLR and PLR.

## Key findings

- Non-responders had significantly higher SII, NLR, and PLR than responders.
- SII outperformed NLR and PLR in predicting IVIG non-responsiveness.
- All three markers were independent risk factors for IVIG non-responsiveness.

## Abstract

This retrospective study assesses whether the systemic immune‐inflammation index (SII) is a better predictor of intravenous immunoglobulin (IVIG) non‐responsiveness (IVIG‐NR) in children with Kawasaki disease (KD children) than the neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR).

After 458 pediatric KD patients were categorized as IVIG responders or non‐responders, blood test data were collected from both groups prior to IVIG administration. Upon SII, NLR, and PLR calculation, IVIG‐NR predictive performances of these markers were evaluated through receiver operating characteristic curve evaluation, and IVIG‐NR risk factors (RFs) were determined by multivariate logistic regression.

Compared to IVIG responders, the non‐responders showed significantly higher NLR, PLR, and SII (p‐values < 0.05). The cut‐off values of these markers for optimal IVIG‐NR prediction were 4.245, 147.736, and 1465.238, respectively.

Although all three of them were the independent RFs for IVIG‐NR in KD children, SII was a better IVIG‐NR predictor than NLR and PLR.

Compared to IVIG responders, the non‐responders showed significantly higher NLR, PLR, and SII (p‐values < 0.05). SII was a better IVIG‐NR predictor than NLR and PLR.