Evaluating the Lowest Post-IVIG Body Temperature as a Predictor of Treatment Response in Kawasaki Disease

Introduction Intravenous immunoglobulin (IVIG) is the standard therapy for Kawasaki disease (KD), reducing inflammation and coronary artery complications. However, some patients exhibit IVIG resistance. This study aimed to identify markers of IVIG efficacy in KD. Methods A retrospective analysis included KD patients treated with IVIG from January 2011 to September 2023. Patients were divided into IVIG-sensitive and IVIG-resistant groups. Data from those diagnosed before October 2022 formed the development dataset, while later cases comprised the validation dataset. Results Among 123 patients, 110 were IVIG-sensitive and 13 were IVIG-resistant. The lowest post-IVIG body temperature (BT) was significantly lower in the IVIG-sensitive group. A BT threshold of 36.05 °C showed sensitivity of 69.2% and specificity of 79.1%. Combining BT with pre-IVIG scoring systems improved specificity to 85.5%–93.6%. Discussion The lowest post-IVIG BT is a potential predictor of IVIG response, enhancing accuracy when combined with scoring systems.